Mr. Jones. 65-year-old male patient with a history of COPD is admitted to the hospital for exacerbation. He is using accessory muscles to breathe and exhibits a respiratory rate o breaths per minute. His oxygen saturation is 88% on room air. What is the most appropriate nursing intervention for a patient with COPD who is experiencing increased shortness of breath?

A. Bronchodilators, such as short-acting beta-agonists (e.g., albuterol), relax airway smooth muscles, reduce bronchospasm, and improve airflow. This is the primary intervention for acute exacerbations of COPD, as it immediately helps relieve dyspnea, improve oxygenation, and decrease the work of breathing. Administering therapy as prescribed is essential for stabilizing respiratory status. B. Supine positioning can worsen dyspnea in patients with COPD because it restricts diaphragmatic movement and lung expansion. Patients often feel more comfortable sitting upright or in a tripod position, which facilitates better ventilation and oxygenation. C. Similar to option B, lying flat increases respiratory effort and can decrease oxygen saturation. Encouraging an upright or semi-Fowler’s position supports effective breathing mechanics and reduces the sensation of shortness of breath. D. There is no immediate indication to restrict fluids in acute COPD exacerbation unless the patient has a coexisting condition (e.g., heart failure). Proper hydration is important to help thin secretions, making airway clearance easier. Fluid restriction would not improve acute dyspnea.