What action should be taken when a patient on long-term supplemental oxygen via transtracheal oxygen catheter complains of shortness of breath?

• A. Administer aerosolized Ipratropium Bromide (Atrovent)
• B. Suction the catheter and recheck oxygen saturation
• C. Remove the transtracheal catheter and begin mechanical ventilation
• D. Begin supplemental oxygen delivery by nasal cannula

Answer: (D)

When a patient on long-term supplemental oxygen via a transtracheal oxygen catheter complains of shortness of breath, the recommended action is to begin supplemental oxygen delivery by nasal cannula. This approach is appropriate as it provides an immediate source of oxygen, which can help alleviate the patient's acute symptoms. It is essential to ensure that the patient’s oxygen needs are adequately met, particularly when they are experiencing shortness of breath, indicating that their current oxygen delivery method may be insufficient or compromised.

Using a nasal cannula allows for a more straightforward and potentially more effective means of delivering higher concentrations of oxygen compared to the transtracheal catheter, especially if there is a blockage or malfunction with the catheter itself. Additionally, this method is generally well-tolerated and can be quickly implemented.

In contrast, suctioning the catheter may not address the underlying issue if there is no visible blockage, and it may also further distress the patient. Administering aerosolized Ipratropium Bromide, while useful for bronchospasm, does not directly provide oxygen, which is the immediate need in this scenario. Lastly, removing the transtracheal catheter and beginning mechanical ventilation is an more invasive step that may not be warranted unless the patient shows signs of significant