The client is admitted with chronic obstructive pulmonary disease and congestive heart failure. He is receiving 2 liters of oxygen via nasal cannula with an oxygen saturation of 89%. The nurse assesses the client who is watching TV and resting comfortably. Identify the nurse’s next appropriate action.

Choice A reason: Increasing the oxygen level may seem appropriate because the saturation is 89%, but in clients with COPD, oxygen therapy must be carefully titrated. These patients rely on hypoxic drive to stimulate breathing, and excessive oxygen can suppress respiratory drive, leading to CO2 retention and respiratory failure. Since the client is resting comfortably and not in distress, increasing oxygen is not the immediate action. Choice B reason: Administering PRN furosemide is indicated for fluid overload in congestive heart failure, typically when there are signs such as pulmonary edema, crackles, or dyspnea. In this case, the client is resting comfortably without evidence of acute fluid overload, so furosemide is not warranted. Choice C reason: Delivering PRN albuterol is appropriate for acute bronchospasm or wheezing. The client is not showing signs of respiratory distress, wheezing, or bronchospasm. Therefore, albuterol is not necessary at this time. Choice D reason: Continuing to monitor is the most appropriate action. The client’s oxygen saturation of 89% is acceptable for a COPD patient, as their target range is often 88–92%. Since the client is comfortable and stable, the nurse should continue monitoring while avoiding unnecessary interventions that could destabilize the patient’s condition.