For a client with COPD presenting with an oxygen saturation of 86%, what should the nurse's first action be?

• A. Administer bronchodilator therapy
• B. Place the client in a supine position
• C. Apply supplemental oxygen
• D. Prepare for intubation

Answer: (C)

In the scenario where a client with Chronic Obstructive Pulmonary Disease (COPD) presents with an oxygen saturation of 86%, the most appropriate first action is to apply supplemental oxygen. This is crucial because the primary concern with a low oxygen saturation is the need to improve oxygen delivery to the body's tissues. Due to the compromised lung function in COPD patients, they often experience difficulties in maintaining adequate oxygen levels.

By administering supplemental oxygen, the nurse can help raise the saturation levels and alleviate hypoxemia. Oxygen therapy is a standard intervention in cases of respiratory distress and is vital in managing patients with chronic respiratory conditions, particularly when their oxygen saturation levels are significantly below the normal range (typically 95-100%).

It's important to note that while bronchodilator therapy may also be necessary for relieving bronchospasm and improving airflow, the immediate priority should always be to correct the hypoxia. Placing the client in a supine position is generally not advantageous for respiratory distress; a more upright position is often preferred to enhance lung expansion and oxygenation. Lastly, preparing for intubation typically represents a more critical situation and should be considered only if the client's respiratory status does not improve or worsens despite earlier interventions.