Hypoxia can cause disorientation and confusion, especially in older adults. The patient is at increased risk of hypoxia due to her COPD and assessment of her oxygenation status should be the first priority. Having someone sit with the patient may become necessary, but assessment of her oxygenation is a higher priority. Listening to lung sounds will not provide information about the patient’s oxygenation and is not as high a priority as checking the patient’s oxygenation. The nurse should assess the patient prior to contacting the physician.