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Nursing QUESTION #9296
Question 1

A patient with chronic obstructive pulmonary disease (COPD) is admitted in respiratory distress. Why should high-flow oxygen (>2–3 L/min) be used cautiously in COPD patients?

  • COPD patients are allergic to high oxygen

  • High oxygen destroys lung tissue in COPD

  • In COPD, hypoxic drive (not CO₂) stimulates breathing; high O₂ removes this drive and may cause respiratory depression

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  • High oxygen causes bronchospasm in COPD

Correct Answer Explanation

In healthy individuals, breathing is driven by rising PaCO2. However, in patients with chronic COPD:

  • They are chronically hypercapnic (high CO₂) and their chemoreceptors become desensitized to CO₂
  • Their primary breathing stimulus becomes hypoxia (low O₂) — the hypoxic drive

If high-flow O₂ is administered:

  • Hypoxia is corrected → hypoxic drive is removed
  • The patient's respiratory effort decreases → CO₂ retention worsens (hypercapnia)
  • Can lead to CO₂ narcosis and respiratory arrest