For a COPD patient with worsening dyspnea, the recommended initial positioning and oxygen approach is:

For a COPD patient with worsening dyspnea, the recommended initial positioning and oxygen approach is:

• A. Elevate HOB and provide supplemental oxygen
• B. Place in Trendelenburg position and withhold oxygen
• C. Keep patient flat and withhold fluids
• D. Administer IV diuretics only

Answer: (A)

Positioning and oxygenation are the first things to optimize when a COPD patient has worsening dyspnea. Elevating the head of the bed helps the chest wall expand more easily, reduces the work of breathing, and improves breathing mechanics by allowing better diaphragmatic movement and ventilation-perfusion matching. Providing supplemental oxygen corrects low oxygen levels and should be titrated to keep SpO2 in the COPD target range (typically around 88–92%) to avoid both hypoxemia and unnecessary CO2 retention. The other options mismanage either the positioning or the oxygen needs: Trendelenburg increases venous return and can worsen breathing effort, staying flat further limits chest expansion, and giving IV diuretics alone doesn’t address the immediate gas-exchange problem. So, elevating the head of the bed and providing supplemental oxygen is the best initial approach.