A patient with COPD on mechanical ventilation continues to wheeze despite albuterol treatment. What should the respiratory therapist recommend?

In this scenario, recommending the addition of ipratropium bromide is appropriate. Ipratropium is an anticholinergic bronchodilator that can be used in conjunction with beta-agonists like albuterol to provide broader bronchodilation. In patients with chronic obstructive pulmonary disease (COPD), combining these medications can help alleviate symptoms more effectively, especially when a patient continues to experience wheezing despite beta-agonist therapy.

The use of ipratropium can enhance airflow by acting on different receptors compared to albuterol, thus providing a synergistic effect in improving bronchial dilation. This combination is often part of standard treatment protocols for COPD patients experiencing acute exacerbations or ongoing respiratory distress.

In contrast, other strategies like increasing the albuterol dosage may not provide additional benefit if the patient is already receiving appropriate doses, and switching to a different beta agonist may not address the underlying issue as effectively as adding another class of medication. Simply administering oxygen does not resolve the wheezing and could lead to insufficient treatment of the underlying bronchospasm. Therefore, the best approach is to add ipratropium bromide to the current regimen.