N5451 Skills Lab > Video Quizzes > Module 16. Oxygenation

The nurse is setting up the equipment needed to deliver oxygen to a postsurgical client via a nasal cannula. After connecting the nasal cannula to the oxygen source and flow meter, what is the next action the nurse should perform?

Adjust the flow rate to the prescribed amount.

The nurse is using a pulse oximeter to monitor a client's oxygen saturation following abdominal surgery to ensure adequate oxygenation. The health care provider has set a parameter of 92%. How would the nurse maintain this parameter?

Adjusting the flow of oxygen to maintain an oxygen saturation level at or above 92%.

As prescribed by the health care provider, the nurse has set up an oxygen mask with a reservoir to deliver oxygen to a client with pneumonia. What would the nurse do, prior to putting the mask on the client?

Allow the reservoir bag to fill up with oxygen.

The nurse is preparing to suction the nasopharyngeal airway of a client admitted with chronic obstructive pulmonary disease. What would the nurse do?

Apply suction when withdrawing the catheter.

The nurse is caring for five clients on a busy medical floor. Which tasks can the nurse delegate to unlicensed assistive personnel (UAP)? Select all that apply.

Bathing and shaving of a client on continuous oxygen at 2 liters per minute via nasal cannula. Ambulating in the hall a client who always uses portable oxygen via nasal cannula. Reapplying the nasal cannula after the client dislodges it during repositioning.

What assessment would the nurse make prior to using a pulse oximeter to measure oxygen saturation?

Capillary refill.

A nurse is suctioning a client with a congested airway. The nurse has just removed the catheter from the client's naris and knows that the client will need additional suctioning. What would the nurse do next?

Insert the catheter into the sterile saline solution to flush it.

A nurse is caring for a client receiving oxygen at 2 liters per minute via nasal cannula. During the morning assessment, the nurse notes reddened areas at the top of the ears and neck. What actions should the nurse take? Select all that apply.

Loosen the nasal cannula tubing to ensure the tubing is not too tight. Request a consult by a skin care team to determine further actions. Apply padding to the tubing that goes over the ears and loosen neck tubing.

A nurse is caring for five clients on a busy surgical unit. Which tasks can the nurse delegate to the unlicensed assistive personnel (UAP)? Select all that apply.

Perform oropharygeal suctioning for a client who was admitted with a stroke; Complete oral hygiene for a client admitted with recurrent falls and dementia; Feeding lunch to a client admitted with new bilateral upper extremity fractures.

The nurse is applying an oxygen mask prescribed for a client with bronchial pneumonia. What would the nurse do to prevent skin breakdown in the area where the mask is placed?

Place gauze pads under the elastic strap at pressure points.

The nurse is turning on the pulse oximeter and notices a bar form on the machine. What does this bar represent?

Signal strength.

A nurse is caring for a client with chronic obstructive pulmonary disease that requires frequent nasopharyngeal suctioning. After putting on the face shield and sterile gloves, but before picking up the catheter, the nurse's dominant hand touches the bedside table. What should the nurse do?

Stop and change into a new pair of sterile gloves before picking up the catheter.

The nurse is checking a client's oxygen saturation level using a pulse oximeter. How should the probe be placed on the finger?

With the light‑emitting sensor and light‑receiving sensor opposite each other.

The nurse has finished suctioning the airways of a client with cystic fibrosis. What personal protective equipment (PPE) would the nurse remove first?

gloves

A health care provider prescribes oxygen for a client at 4 liters per minute via a nasal cannula after an initial pulse oximeter reading of 88% on room air. Which is the priority client assessment that the nurse should make prior to administering the oxygen?

respiratory rate and effort

A nurse is educating a client on the use of continuous oxygen. The nurse asks the client, "What is the advantage of using an oxygen mask versus a nasal cannula?" The nurse confirms that the education has been effective if the client states:

"I will have a greater concentration of oxygen delivered."

The health care provider prescribes oxygen to be administered to a client via a mask with an oxygen flow rate of 10 liters per minute. To accommodate meals, what would the nurse do?

Deliver oxygen via nasal cannula during meals, replacing the mask after the client eats.

The nurse is using a pulse oximeter to monitor a client who is receiving oxygen therapy via a nasal cannula. The nurse explains to the client that which factor might affect the results of pulse oximetry?

Alterations in circulation.

What would the nurse use to prepare the site for attachment of a pulse oximeter probe?

An alcohol wipe.

The nurse is inserting a nasal cannula into the client's nostrils to improve oxygenation. To correctly insert the curved prongs of the cannula, what would the nurse do?

Follow the angle of the nose with the prongs pointed downward.

A nurse is caring for multiple clients on a busy medical unit. Which client would require the nurse to use surgical asepsis and don personal protective equipment (PPE) during care?

a client with bronchitis who needs nasopharyngeal suctioning A nurse is suctioning a client with a congested

The nurse on a telemetry unit is assessing oxygen saturation of a client admitted with severe peripheral edema using a pulse oximeter. The nurse obtains a weak and inaccurate pulse oximeter reading. What actions constitute the correct response by the nurse? Select all that apply.

Use an ear pulse oximeter probe on one of the client's ears. Request a prescription for an arterial blood gas level by the lab.

The nurse has finished suctioning the airways of a client with bronchial pneumonia. What would the nurse do first when disposing of the catheter and supplies?

Wrap the catheter around a gloved hand and remove gloves.

The nurse has attached the probe of a pulse oximeter to the finger of a client to monitor oxygen saturation. The nurse notices that the oximeter reads a low saturation of 88 percent with irregular meter pulsations; however, upon assessment of the client, the nurse finds no symptoms of respiratory distress. What might be causing this failure to obtain an accurate reading?

Peripheral vascular disease.

The nurse is preparing the site for applying the probe of a pulse oximeter. What would the nurse do to ensure accurate results?

Remove any nail polish on the client's fingers.

A nurse is suctioning a client's airway with a nasopharyngeal catheter. During the suctioning, the client is gagging and seems likely to vomit. What should the nurse do? Select all that apply.

Remove the catheter to avoid entering the esophagus inadvertently. Turn the client to the side and elevate the head of bed to prevent aspiration.

The nurse is caring for a client receiving oxygen at a rate of 8 liters per minute via face mask. While monitoring the client for skin irritation, what is the best action by the nurse?

Remove the mask and dry the skin every 2 to 3 hours.

The nurse is suctioning the nasopharyngeal airway of a client and notices that the secretions coming out are tinged with blood. What would the nurse do?

Stop suctioning, replace oxygen, check vital signs, and notify health care provider.

A nurse is caring for a client with end-stage lung cancer and who requires nasopharyngeal suctioning. As the nurse is preparing to insert the catheter into the naris, the tip touches the client's cheek. What should the nurse do?

Stop the suctioning procedure and get a new catheter.

The nurse is checking capillary refill to measure circulation in the client's index finger prior to using a pulse oximeter. What would be the next best site to place the probe if circulation is found to be inadequate at this site?

The bridge of the nose.

The nurse is using a pulse oximeter to measure the oxygen saturation for a client with lung cancer. Normally, where would the nurse place the probe of the device?

The index finger.