For some COPDers, it might be the best they can get.
But if you find someone like that, I'd make sure they have O2 @ 2 L on, and keep monitoring them. If they're telling you, "Oh, that's a good number for me," and don't seem to be in distress, that's your clue that you have a COPDer. Monitor them so they don't get any worse. If they have Neb treatments ordered, they might need one.
However, if the patient is having sternal retractions, shortness of breath and has no O2 on, and is alert and oriented, there are several things you want to do immediately.
Call the Respiratory Therapist. Monitor O2 sats continuously. Get vitals and be ready to call the doc.
While someone else runs to get the O2 tubing, reposition the patient. Get the patient up at the top of the mattress, and crank them up to a high Fowler's. Don't forget to crank the legs flat.
This is truly one nursing intervention that many people overlook. Make sure the patient isn't slouching or slumped in the bed as it encroaches on their lung capacity. A lot of breathing is mechanical. I've seen many patients improve dramatically within a few minutes of performing this intervention.
Oxygenate. If the nasal cannula full blast isn't effective, try a Venti-mask. If that doesn't work, do a non-rebreather. (Hook up the O2, and remember to let that blow the bag up before you apply it, otherwise it's useless.)
Now have the patient lean forward slightly so you can LISTEN to their lungs. What do you hear? Crackles? You have a CHFer, so crank up the O2, get the doc on the phone and ask for Lasix. Be ready fast, because CHFers go downhill scarily fast.
Wheezes? Rhonchi? No air moving much at all? Could be a few things, but an Albuterol/Atrovent Neb treatment might help.
Breathing is also very psychological. That is, if the patient believes
no air is getting in, their resps will increase, become more shallow, and they really won't
get any air. Teach the patient how to get more air by breathing slower ("Count to 10 with me as you inhale and exhale") and deeper. Remind them that they don't have to "feel" the air to be actually getting air.
This too, is a nursing intervention. It's based on trust. The patient has to trust you in order to let go of their own reflex to breathe faster and do this successfully. These patients have my utmost respect, because it's like trying to tell a drowning person not to thrash.
Not successful yet? Call a Code and prepare to intubate.
Anyhow....just thought I'd share a little. Anyone else have something to add?