A patient is admitted with hypercapnic respiratory failure secondary to chronic obstructive pulmonary disease (COPD). The nurse anticipates which collaborative interventions to address the patient's condition? Select all that apply.

A. Collaborate with respiratory therapy for airway clearance techniques: Patients with COPD and hypercapnic respiratory failure often retain secretions due to impaired mucociliary clearance. Airway clearance techniques, such as chest physiotherapy, suctioning, and assisted coughing, help mobilize secretions, improve ventilation, and reduce the risk of infection. B. Initiate non-invasive positive pressure ventilation (NIPPV): NIPPV, such as CPAP or BiPAP, supports ventilation by improving alveolar ventilation and reducing CO₂ retention in hypercapnic respiratory failure. It can prevent respiratory muscle fatigue and reduce the need for invasive mechanical ventilation, making it a key intervention in stable patients. C. Administer bronchodilators as prescribed: Bronchodilators, including short-acting beta-agonists or anticholinergics, help relieve airway obstruction by relaxing bronchial smooth muscle. This improves airflow, gas exchange, and CO₂ elimination, directly addressing the pathophysiology of hypercapnic respiratory failure in COPD. D. Prepare for possible endotracheal intubation: In cases where non-invasive measures fail or the patient becomes fatigued, hypoxic, or obtunded, endotracheal intubation with mechanical ventilation may be necessary. Early preparation ensures readiness for rapid intervention if respiratory failure progresses. E. Begin high-flow oxygen therapy at 100% FiO₂: Administering high concentrations of oxygen can suppress the hypoxic drive in COPD patients, worsening hypercapnia. Oxygen therapy should be titrated carefully to maintain SaO₂ of 88–92%, not delivered at 100% unless clinically indicated in acute severe hypoxemia. F. Encourage vigorous physical activity to improve ventilation: Vigorous activity in a patient with acute hypercapnic respiratory failure may exacerbate hypoxemia and fatigue respiratory muscles. Activity should be carefully graded and only encouraged once the patient is stabilized.