A COPD client arrives in the emergency department with shortness of breath. What should the nurse do first?

• A. Administer oxygen
• B. Assess airway and breathing
• C. Obtain arterial blood gas
• D. Initiate nebulizer treatment

Answer: (A)

Immediate stabilization of oxygenation is the priority when a COPD patient presents with shortness of breath. Giving supplemental oxygen promptly improves arterial oxygen content, reduces work of breathing, and helps prevent rapid deterioration while you continue to assess and treat the patient. Titrating oxygen to a target level (often 88–92% for COPD, adjusted to the individual) avoids both hypoxemia and potential CO2 retention. After starting oxygen, you would continue to evaluate airway patency and breathing and proceed with further interventions as needed, such as nebulizers or diagnostics like arterial blood gas analysis.