Nclexrn Flashcards: Oxygen Therapy Indications And Device Selection

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Oxygen Therapy Indications And Device Selection

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

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ANSWER

Venturi mask. Precise FiO2_2 control maintains hypoxic drive, preventing CO2_2 retention in hypercapnia-prone patients.

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Flashcard 1: Which device is preferred for a COPD patient needing controlled oxygen delivery to avoid worsening hypercapnia?

Answer: Venturi mask. Precise FiO2_2 control maintains hypoxic drive, preventing CO2_2 retention in hypercapnia-prone patients.

Flashcard 2: Which intervention is most important to reduce fire risk during oxygen therapy?

Answer: Keep oxygen away from flames/sparks and prohibit smoking. Oxygen supports combustion, making fire prevention critical in oxygen-enriched environments.

Flashcard 3: Which monitoring parameter best evaluates the immediate effectiveness of oxygen therapy at the bedside?

Answer: Pulse oximetry (SpO2SpO_2). Non-invasively measures saturation continuously, guiding titration for optimal therapy response.

Flashcard 4: Which therapy provides two pressure levels to improve ventilation and is often used for COPD exacerbation?

Answer: BiPAP. Biphasic pressures support inspiration and expiration, reducing work of breathing in ventilatory failure.

Flashcard 5: Which device should be used for a patient requiring a fixed oxygen concentration when respiratory rate is variable?

Answer: Venturi mask. Fixed air-oxygen mixing ensures consistent FiO2_2 despite changes in tidal volume or rate.

Flashcard 6: What SpO2SpO_2 target range is commonly used for patients at risk for hypercapnic respiratory failure (COPD)?

Answer: 88%88\% to 92%92\%. Lower targets prevent suppression of hypoxic drive, reducing hypercapnia risk in susceptible patients like those with COPD.

Flashcard 7: What minimum flow rate is required for a simple face mask to prevent carbon dioxide rebreathing?

Answer: 5 L/min\geq 5\ \text{L/min}. Higher flows flush exhaled CO2_2 from the mask, preventing rebreathing and hypercapnia.

Flashcard 8: Which device should be selected for a patient with severe hypoxemia who is breathing spontaneously and needs rapid support?

Answer: Nonrebreather mask. Delivers near 100% FiO2_2 quickly via reservoir, stabilizing acute severe oxygen deficits.

Flashcard 9: Which oxygen device delivers the lowest oxygen concentration and is used for stable, mild hypoxemia?

Answer: Nasal cannula. Provides low-flow oxygen comfortably for patients with minimal needs, allowing eating and talking.

Flashcard 10: Which therapy primarily improves oxygenation by providing continuous positive airway pressure to keep alveoli open?

Answer: CPAP. Maintains alveolar recruitment throughout breathing cycles, enhancing gas exchange in conditions like sleep apnea.

Flashcard 11: Which device is used to deliver humidified oxygen to a patient with an endotracheal tube or tracheostomy?

Answer: T-piece (Briggs adapter). Connects to the tube for humidified oxygen delivery while allowing exhalation and secretion clearance.

Flashcard 12: Which oxygen device is most appropriate for long-term home oxygen therapy with stable chronic hypoxemia?

Answer: Nasal cannula. Offers comfort and mobility for continuous low-flow oxygen in stable chronic conditions.

Flashcard 13: Which oxygen delivery method is used for patients with a tracheostomy who need humidified oxygen?

Answer: Tracheostomy collar. Delivers humidified oxygen directly over the tracheostomy site, preventing airway drying.

Flashcard 14: Which device is appropriate for a mouth-breathing patient needing moderate oxygen (higher than cannula)?

Answer: Simple face mask. Covers both nose and mouth, providing 40-60% FiO2_2 for patients requiring more than nasal cannula.

Flashcard 15: What is the priority setup step for a nonrebreather mask before placing it on the patient?

Answer: Inflate reservoir bag before application. Filling the bag ensures oxygen availability and confirms proper device function for high FiO2_2 delivery.

Flashcard 16: Which test provides the most definitive assessment of oxygenation and ventilation when SpO2SpO_2 is unreliable?

Answer: Arterial blood gas (ABG). Directly assesses PaO2_2, PaCO2_2, and pH, essential when pulse oximetry is inaccurate due to factors like poor perfusion.

Flashcard 17: Which device is contraindicated for a patient who cannot protect the airway or has frequent vomiting?

Answer: Noninvasive ventilation (CPAP/BiPAP). Positive pressure increases aspiration risk in patients unable to clear secretions or with emesis.

Flashcard 18: Which device provides high FiO2FiO_2 for a spontaneously breathing patient in acute hypoxemia (not intubated)?

Answer: Nonrebreather mask. Uses a reservoir and valves to deliver up to 90-100% FiO2_2, minimizing air dilution for severe cases.

Flashcard 19: Which oxygen device provides the most precise FiO2FiO_2 and is preferred when exact titration is required?

Answer: Venturi mask. Adapters control air entrainment, ensuring fixed FiO2_2 regardless of breathing patterns.

Flashcard 20: What is the typical oxygen flow rate range for an adult nasal cannula?

Answer: 11 to 6 L/min6\ \text{L/min}. Delivers approximately 24-44% FiO2_2, suitable for correcting mild hypoxemia without excessive drying.

Flashcard 21: What key nursing intervention helps prevent nasal mucosal dryness in a patient on nasal cannula oxygen?

Answer: 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.

Flashcard 22: What clinical finding is the most common indication to start supplemental oxygen therapy?

Answer: Hypoxemia (low oxygenation evidenced by low SpO2SpO_2 or PaO2PaO_2). Indicates inadequate blood oxygen levels, requiring supplementation to prevent tissue hypoxia and organ damage.

Flashcard 23: What is the usual target SpO2SpO_2 range for most acutely ill adult patients on oxygen therapy?

Answer: 94%94\% to 98%98\%. This range ensures adequate oxygenation while reducing the risk of oxygen toxicity in acutely ill patients.

Flashcard 24: Which finding suggests oxygen toxicity risk and indicates the need to reassess high FiO2FiO_2 therapy?

Answer: Worsening cough, chest pain, or dyspnea with prolonged high FiO2FiO_2. Prolonged exposure to high oxygen levels can cause lung inflammation, necessitating FiO2_2 reduction.

Flashcard 25: Which device is appropriate when a patient needs high-flow, warmed, humidified oxygen via nasal prongs?

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