Which finding would indicate the patient with COPD on supplemental oxygen is not adequately oxygenated?

• A. SpO2 95% on oxygen
• B. SpO2 88% on oxygen
• C. No dyspnea with activity
• D. Normal respiratory rate

Answer: (B)

SpO2 is a quick snapshot of how much oxygen the blood is carrying, and in COPD patients receiving oxygen, we aim to keep that saturation in a safe, target range to ensure tissues are oxygenated without causing other issues. An SpO2 of 88% while on supplemental oxygen means there’s ongoing hypoxemia despite therapy, so oxygenation is not adequate and needs urgent review—check the delivery system for proper FiO2, adjust the oxygen flow as prescribed, and consider further evaluation (including an arterial blood gas) to assess PaO2 and PaCO2 and to look for reasons like disease progression or an acute illness.

SpO2 of 95% on oxygen would indicate that oxygenation is adequate. Lack of dyspnea with activity and a normal respiratory rate can occur in stable patients and doesn’t by itself prove adequate oxygenation, though it’s a reassuring sign; the key indicator here is the low SpO2 on supplemental oxygen.