For a patient with a history of cor pulmonale receiving oxygen at 2 L/min, which action is most appropriate to achieve a target SpO2 of 90%?

The choice to switch to an air-entrainment mask at 28% is appropriate for managing a patient with cor pulmonale who is receiving supplemental oxygen. In cor pulmonale, which is right heart failure caused by chronic lung disease, maintaining an appropriate oxygen saturation is critical, but caution is needed to prevent hypercapnia, which can occur when high concentrations of oxygen are delivered.

Using an air-entrainment mask (also known as a venturi mask) allows for precise control over the concentration of oxygen being administered, while also allowing for air to be entrained. This results in a more controlled increase in oxygen levels without significantly increasing the risk of CO2 retention, which is paramount in patients with chronic respiratory issues, such as those with cor pulmonale.

By delivering oxygen at a set percentage, such as 28%, the patient can maintain a target SpO2 of around 90% effectively while minimizing potential complications from excessive oxygen delivery. This method also helps preserve the physiological drive to breathe, which could be affected by high supplemental oxygen levels.

Increasing the flow to 4 L/min or administering a non-rebreather mask would deliver higher concentrations of oxygen and could risk hypercapnia in a patient with respiratory compromise. Using non-invasive ventilation (