5. Medication and treatment monitoring

Monitor the COPD regimen for delivery, effect, and adverse effects, correlating with the ordered parameters:

• Maintenance inhalers — long-acting bronchodilators (LABA, LAMA) and, where indicated, inhaled corticosteroid — for adherence, technique, and effect; note that inhaled-corticosteroid use raises pneumonia risk and warrants oral-care and infection awareness.
• Short-acting rescue therapy — frequency against the ordered limit and whether it is escalating.
• Exacerbation courses — an oral corticosteroid and, where sputum is increased and purulent, an antibiotic per order, with monitoring for glucose elevation on steroids (cross-reference Diabetes overlay where applicable) and for treatment response.
• Home oxygen — the ordered flow, the delivery system, and cannula-skin integrity, without titrating above the ceiling.
• Nebulized therapy where ordered — technique, cleaning, and effect.
• Biologic therapy for an eosinophilic phenotype where prescribed under the current GOLD report (for example dupilumab or mepolizumab) — administration or adherence and adverse-effect monitoring per order.
• Vaccine status relevant to COPD (influenza, pneumococcal, and others per the current schedule) as an exacerbation-prevention measure.