Prescribing Safety Assessment (PSA) Practice Exam

What is the safest oxygen concentration level for use in COPD patients awaiting confirmation?

1. 21%

2. 28%

3. 100%

4. 40%

The correct answer is: 28%

For patients with Chronic Obstructive Pulmonary Disease (COPD), managing oxygen levels is critical, especially when considering their need for supplemental oxygen while waiting for diagnostic confirmation. In patients with COPD, there is a risk of hypoventilation due to high levels of oxygen, which can lead to carbon dioxide retention and respiratory acidosis. Using 28% oxygen concentration is generally considered safe for these patients because it provides a modest increase in oxygen levels without significantly reducing their respiratory drive. In COPD, patients often rely on a lower baseline oxygen saturation; thus, providing a moderate increase helps to prevent complications associated with higher oxygen concentrations. In contrast, options like 100% oxygen can cause oxygen toxicity and suppress the respiratory drive further, leading to a state of hypercapnia (increased carbon dioxide in the blood). Similarly, higher concentrations, such as 40%, can also pose risks as they may further depress respiratory function in these patients. Therefore, 28% strikes a balance by safely improving oxygenation while minimizing the risks of respiratory depression associated with higher concentrations.