A patient is demonstrating increased work of breathing and remains hypoxic despite supplemental oxygen by nonrebreathing mask. What should the respiratory therapist recommend?

In cases where a patient exhibits increased work of breathing and hypoxia despite being on supplemental oxygen via a nonrebreathing mask, recommending non-invasive positive pressure ventilation (NIPPV) is an appropriate intervention. NIPPV can provide respiratory support by delivering pressurized air to help inflate the lungs and improve ventilation without the need for intubation. This method can assist in alleviating the work of breathing, improve oxygenation, and reduce the effort required for the patient to breathe.

NIPPV is particularly beneficial for patients who may have conditions such as exacerbated COPD, pulmonary edema, or respiratory failure that are not adequately addressed by supplemental oxygen alone. This form of therapy allows for better oxygen exchange and can help in reversing hypoxemia while supporting the patient's respiratory efforts.

Other interventions, like administering Ativan, may not address the underlying respiratory issues and could potentially depress respiratory drive. Full mechanical ventilatory support could be considered as a last resort if NIPPV is unsuccessful, but starting with non-invasive methods can be less invasive and more comfortable for the patient. CPAP therapy, on the other hand, might not be adequate for patients with significant respiratory distress who require assistance with both ventilation and oxygenation.

Therefore, recommending NIPPV is