A client admitted with emphysema is now ready for discharge. The client is dressed and sitting comfortably in a chair reading the newspaper while waiting for their ride. Which action should the nurse take?

• A. Reposition the pulse oximeter probe and recheck saturation level
• B. Begin inhaled bronchodilator therapy
• C. Increase oxygen concentration to maintain saturation above 98%
• D. Schedule pulmonary rehabilitation

Answer: (C)

In emphysema care, you must verify oxygenation and ensure the device is delivering the prescribed amount without causing harm. The best immediate action is to check that the pulse oximeter reading is accurate by repositioning the sensor and rechecking the saturation. Movement, poor sensor contact, or other technical factors can give unreliable readings, and making changes to oxygen therapy based on a faulty reading can harm the patient.

In COPD, oxygen is titrated to a cautious target rather than aiming for near-normal saturations. Pushing oxygen to maintain above 98% can suppress the hypoxic drive and lead to carbon dioxide retention, which is dangerous for a client with emphysema. The typical safe range is around 88–92% (or 90–92% depending on the individual and orders).

Other options aren’t as appropriate for this moment: starting inhaled bronchodilator therapy would be based on a current need and orders, not a discharge readiness step; increasing oxygen to very high levels is unsafe in COPD; and while pulmonary rehabilitation is beneficial, it’s part of long-term planning rather than an immediate discharge assessment action.