A patient is admitted with a diagnosis of chronic obstructive pulmonary disease ( COPD ) and the health care provider orders bi-level positive airway pressure ( BiPAP ) .Which action by the nurse is appropriate?

A) Set the initial bi-level positive airway pressure ( BiPAP ) settings at 4 to 8 cm H₂O for inspiration and expiration.
B) Draw arterial blood gas ( ABG ) levels after the first hour.
C) Make sure the mask does not have quick-release straps.
D) Set the initial BiPAP settings at 4 to 10 cm H₂O for inspiration and at 10 to 15 cm H₂O for expiration.

When bi-level positive airway pressure (BiPAP)is initiated,especially in patients with underlying chronic obstructive pulmonary disease (COPD),it is important to obtain arterial blood gas (ABG)levels after the first hour and then per agency policy (usually every 2 to 6 hours)during the first day because these patients may retain carbon dioxide.BiPAP initial settings are 10 to 15 cm H₂O for inspiratory pressure and 4 to 10 cm H₂O for expiratory pressure.It is imperative that the mask have quick-release straps.In the case of an emergency (e.g. ,vomiting and respiratory arrest),quick-release straps allow the mask to be removed quickly.This system also allows the patient to remove the mask quickly as needed.