Which action best demonstrates ongoing monitoring after initiating oxygen therapy for a COPD patient in the ER?

• A. Regularly monitoring SpO2 and adjusting flow as needed
• B. Documenting the initial rate only
• C. Maintaining oxygen without monitoring
• D. Discontinuing oxygen as soon as symptoms improve

Answer: (C)

Ongoing oxygen therapy requires continuously checking how well the patient is oxygenating and adjusting the delivered oxygen to keep saturations within a safe range. In COPD, titration is crucial because too little oxygen leaves hypoxemia uncorrected, while too much can suppress the drive to breathe and raise CO2, worsening respiratory acidosis. In the ER, this means using continuous pulse oximetry, watching vitals, and regularly reassessing to modify the flow or device to keep SpO2 within the COPD-appropriate target (commonly about 88–92%, or as your protocol dictates). You may also use arterial blood gas measurements to confirm gas exchange when needed. Documenting only the initial rate captures a moment in time and misses changes in the patient’s condition. Keeping oxygen on without ongoing monitoring risks undetected deterioration or over-oxygenation. Stopping oxygen as soon as symptoms improve can lead to a return of hypoxemia if the underlying issue persists.