A patient has been admitted with respiratory distress and a history of chronic obstructive pulmonary disease (COPD). The nurse notes that the patient is using accessory muscles to breathe and is in a tripod position. What is the most appropriate initial nursing intervention to assist this patient?

Chronic obstructive pulmonary disease involves airflow obstruction, air trapping, alveolar destruction, and ventilation-perfusion mismatch, leading to hypoxemia, hypercapnia, increased work of breathing, and reliance on accessory respiratory muscles during acute exacerbations and respiratory distress states. Rationale: A. Administration of bronchodilator therapy reverses bronchospasm and reduces airway resistance in COPD exacerbation. It improves expiratory airflow and decreases air trapping. This directly relieves dyspnea and accessory muscle use. It is the most immediate targeted intervention for acute respiratory distress. B. High flow oxygen risks worsening CO2 retention in COPD patients due to hypoventilation suppression. Excess oxygen may blunt hypoxic respiratory drive and increase hypercapnia. Oxygen must be titrated carefully to target saturation ranges. It is not the safest initial intervention without controlled dosing. C. Encouraging deep breaths may increase air trapping and fatigue in obstructed airways. COPD patients cannot effectively exhale fully due to narrowed bronchi. This may worsen dynamic hyperinflation and respiratory distress. It is not appropriate during acute exacerbation. D. Supine positioning worsens lung expansion and reduces diaphragmatic efficiency in respiratory distress. It increases work of breathing and compromises ventilation. COPD patients benefit from upright or tripod positioning. Flat positioning aggravates dyspnea and should be avoided.