A patient with chronic COPD is scheduled for surgery. Which action should the nurse prioritize to minimize respiratory complications?

Chronic obstructive pulmonary disease is characterized by airflow limitation, mucus hypersecretion, loss of elastic recoil, and air trapping, leading to reduced expiratory flow and increased risk of perioperative complications such as atelectasis, hypoxemia, and retained secretions due to impaired ventilation mechanics. Rationale: A. Positioning a COPD patient supine decreases diaphragmatic excursion and worsens ventilation, promoting air trapping and reduced functional residual capacity. This increases the risk of postoperative respiratory compromise rather than improving lung expansion. B. Regular use of incentive spirometry promotes alveolar inflation, prevents atelectasis, and improves ventilation-perfusion matching. Preoperative lung expansion exercises optimize pulmonary function and significantly reduce postoperative respiratory complications in COPD patients. C. Excessive fluid intake may worsen bronchial secretions and increase the risk of fluid overload, particularly in patients with compromised cardiopulmonary function. Fluid management must be carefully balanced rather than universally increased. D. Bronchodilators are important in COPD management, but scheduled administration alone is not the most immediate preventive strategy for perioperative complications. They are adjuncts, while lung expansion techniques directly target atelectasis prevention.