Oxygen Therapy: Indications And Device Selection - NCLEX Rn

Which device is preferred for a COPD patient needing controlled oxygen delivery to avoid worsening hypercapnia?

Venturi mask. Precise FiO $_2$ control maintains hypoxic drive, preventing CO $_2$ retention in hypercapnia-prone patients.
Which intervention is most important to reduce fire risk during oxygen therapy?

Keep oxygen away from flames/sparks and prohibit smoking. Oxygen supports combustion, making fire prevention critical in oxygen-enriched environments.
Which monitoring parameter best evaluates the immediate effectiveness of oxygen therapy at the bedside?

Pulse oximetry ( $SpO_2$ ). Non-invasively measures saturation continuously, guiding titration for optimal therapy response.
Which therapy provides two pressure levels to improve ventilation and is often used for COPD exacerbation?

BiPAP. Biphasic pressures support inspiration and expiration, reducing work of breathing in ventilatory failure.
Which device should be used for a patient requiring a fixed oxygen concentration when respiratory rate is variable?

Venturi mask. Fixed air-oxygen mixing ensures consistent FiO $_2$ despite changes in tidal volume or rate.
What $SpO_2$ target range is commonly used for patients at risk for hypercapnic respiratory failure (COPD)?

$88\%$ to $92\%$ . Lower targets prevent suppression of hypoxic drive, reducing hypercapnia risk in susceptible patients like those with COPD.
What minimum flow rate is required for a simple face mask to prevent carbon dioxide rebreathing?

$\geq 5\ \text{L/min}$ . Higher flows flush exhaled CO $_2$ from the mask, preventing rebreathing and hypercapnia.
Which device should be selected for a patient with severe hypoxemia who is breathing spontaneously and needs rapid support?

Nonrebreather mask. Delivers near 100% FiO $_2$ quickly via reservoir, stabilizing acute severe oxygen deficits.
Which oxygen device delivers the lowest oxygen concentration and is used for stable, mild hypoxemia?

Nasal cannula. Provides low-flow oxygen comfortably for patients with minimal needs, allowing eating and talking.
Which therapy primarily improves oxygenation by providing continuous positive airway pressure to keep alveoli open?

CPAP. Maintains alveolar recruitment throughout breathing cycles, enhancing gas exchange in conditions like sleep apnea.
Which device is used to deliver humidified oxygen to a patient with an endotracheal tube or tracheostomy?

T-piece (Briggs adapter). Connects to the tube for humidified oxygen delivery while allowing exhalation and secretion clearance.
Which oxygen device is most appropriate for long-term home oxygen therapy with stable chronic hypoxemia?

Nasal cannula. Offers comfort and mobility for continuous low-flow oxygen in stable chronic conditions.
Which oxygen delivery method is used for patients with a tracheostomy who need humidified oxygen?

Tracheostomy collar. Delivers humidified oxygen directly over the tracheostomy site, preventing airway drying.
Which device is appropriate for a mouth-breathing patient needing moderate oxygen (higher than cannula)?

Simple face mask. Covers both nose and mouth, providing 40-60% FiO $_2$ for patients requiring more than nasal cannula.
What is the priority setup step for a nonrebreather mask before placing it on the patient?

Inflate reservoir bag before application. Filling the bag ensures oxygen availability and confirms proper device function for high FiO $_2$ delivery.
Which test provides the most definitive assessment of oxygenation and ventilation when $SpO_2$ is unreliable?

Arterial blood gas (ABG). Directly assesses PaO $_2$ , PaCO $_2$ , and pH, essential when pulse oximetry is inaccurate due to factors like poor perfusion.
Which device is contraindicated for a patient who cannot protect the airway or has frequent vomiting?

Noninvasive ventilation (CPAP/BiPAP). Positive pressure increases aspiration risk in patients unable to clear secretions or with emesis.
Which device provides high $FiO_2$ for a spontaneously breathing patient in acute hypoxemia (not intubated)?

Nonrebreather mask. Uses a reservoir and valves to deliver up to 90-100% FiO $_2$ , minimizing air dilution for severe cases.
Which oxygen device provides the most precise $FiO_2$ and is preferred when exact titration is required?

Venturi mask. Adapters control air entrainment, ensuring fixed FiO $_2$ regardless of breathing patterns.
What is the typical oxygen flow rate range for an adult nasal cannula?

$1$ to $6\ \text{L/min}$ . Delivers approximately 24-44% FiO $_2$ , suitable for correcting mild hypoxemia without excessive drying.
What key nursing intervention helps prevent nasal mucosal dryness in a patient on nasal cannula oxygen?

Add humidification when flow is higher or dryness occurs. Moistens oxygen to prevent mucosal irritation, especially at flows above 4 L/min or with patient complaints.
What clinical finding is the most common indication to start supplemental oxygen therapy?

Hypoxemia (low oxygenation evidenced by low $SpO_2$ or $PaO_2$ ). Indicates inadequate blood oxygen levels, requiring supplementation to prevent tissue hypoxia and organ damage.
What is the usual target $SpO_2$ range for most acutely ill adult patients on oxygen therapy?

$94\%$ to $98\%$ . This range ensures adequate oxygenation while reducing the risk of oxygen toxicity in acutely ill patients.
Which finding suggests oxygen toxicity risk and indicates the need to reassess high $FiO_2$ therapy?

Worsening cough, chest pain, or dyspnea with prolonged high $FiO_2$ . Prolonged exposure to high oxygen levels can cause lung inflammation, necessitating FiO $_2$ reduction.
Which device is appropriate when a patient needs high-flow, warmed, humidified oxygen via nasal prongs?

High-flow nasal cannula (HFNC). Provides up to 60 L/min of heated, humidified gas, offering PEEP and improved comfort for moderate hypoxemia.

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