What action should be taken first for a patient with COPD experiencing increased shortness of breath?

• A. Elevate HOB and administer oxygen
• B. Administer diuretics
• C. Obtain chest x-ray
• D. Initiate mechanical ventilation

Answer: (A)

When a patient with COPD experiences increased shortness of breath, the immediate goal is to support breathing and oxygen delivery. Elevating the head of the bed helps with chest expansion and diaphragmatic movement, making breaths easier, while giving supplemental oxygen corrects hypoxemia and improves tissue oxygenation. Together, these address the most urgent physiologic needs and can quickly relieve dyspnea. The other actions don’t address the acute breathing distress as directly: diuretics are only helpful if fluid overload is present, a chest X-ray helps diagnose issues but does not treat the current distress, and mechanical ventilation is reserved for respiratory failure or failure of less invasive measures. After initiating these steps, monitor the patient’s oxygen saturation and breathing effort and adjust treatment as needed.