<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 59-year-old patient with COPD is admitted with difficulty breathing and increased sputum production. Approx. a week ago, he developed an upper respiratory tract infection. On admission, his blood pressure is 13080 mm Hg, the heart rate 92min, the respiratory rate 24min, the temperature 37.6C 99.7F, and SaO2 on room air 87. Chest radiograph shows consolidation in the lower lobe of the right lung. Arterial blood gases ABG are taken and antibiotics are started. A nasal cannula provides 2L of oxygen to the patient. When the ABG results arrive, the patients SaO2 is 93. The results are as follows:pH 7.32PaO2 63 mm HgPaCO2 57 mm HgHCO3- 24 mEqLWhat is the most appropriate next step in the management of this patient?? A: Increase oxygen to SaO2 95, B: Re-take the ABG and observe the patient until the results are available, C: Start non-invasive positive pressure ventilation, D: Intubate and start invasive ventilation, E: Administer oral corticosteroids,  <response>: This is a multiple choice question about the management of a 59-year-old COPD patient admitted with an exacerbation likely due to a respiratory infection. The patient is hypoxemic with an SaO2 of 87 on room air and ABG showing respiratory acidosis pH 7.32, PaCO2 57 mm Hg. With 2L nasal cannula, the SaO2 has improved to 93. The choices include increasing oxygen A, rechecking ABG B, starting NIPPV C, intubating for mechanical ventilation D, and giving steroids E. The key here is that the patient has respiratory acidosis indicating ventilatory failure. Simply increasing oxygen may worsen hypercapnia. NIPPV can help unload respiratory muscles and improve ventilation. Intubation should be reserved for patients who continue to deteriorate on NIPPV. Steroids may help resolve the exacerbation but do not address the acute ventilatory failure. Rechecking ABG is reasonable but does not address the underlying problem.C: Start non-invasive positive pressure ventilation 