A 68-year-old with a history of COPD is breathing spontaneously on a 4 L/min nasal cannula. ABG: pH 7.31, PaCO₂ 61 mmHg, HCO₃⁻ 30 mEq/L, PaO₂ 58 mmHg. The patient is awake, mildly drowsy, and using accessory muscles. What is the most appropriate next action?
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