Problem: Patient is a 29 year old male six feet 2 inches admitted with an exacerbation of COPD pt is alert but slightly confused.
Physical findings
HR 120 BP 136/90 BT 38 degrees RR 24, shallow and labored. B/S are decreased in bases with prolonged expiratory phase. Loose non-productive cough. Pt has an IV and is in a regular room.
Lab Data: Ph 7.32 PaCo2 59 Hco3 32 Pao2 50 SaO2 84%, fio2 .21, WBC 11200, HBG 13.3, hematocrit 44
Orders: Vapotherm with 30LPM and 28%
Would you implement this order as written?
If no what would you recommend in its place?
Are there any other interventions pharmacological or otherwise you would recommend at this time?