A 70-year-old male with end-stage COPD arrives in the emerge…
A 70-year-old male with end-stage COPD arrives in the emergency department with an acute exacerbation. His chart includes a DNI order. On examination, he is febrile, has a weak, non-productive cough, and auscultation reveals bilateral coarse crackles with scattered wheezes. He is started on bronchodilators and antibiotics. Serial arterial blood gases are obtained: 7 PM: pH: 7.30 PaCO₂: 72 mm Hg PaO₂: 47 mm Hg HCO₃⁻: 34 mEq/L SpO₂: 77% on room air 8 PM: pH: 7.22 PaCO₂: 81 mm Hg PaO₂: 56 mm Hg HCO₃⁻: 34 mEq/L SpO₂: 88% on 40% FiO₂ Given these results and the patient’s clinical status, what should the respiratory therapist recommend?