Respiratory Care Modalities - Ch 21

A patient is to receive an oxygen concentration of 70%. What is the best way for the nurse to deliver this concentration? 1. A nasal cannula 2. A partial rebreathing mask 3. An oropharyngeal catheter 4. A Venturi mask

Correct answer: 2. A partial rebreathing mask Nearly half of students who answered this question in Wolters Kluwer's adaptive learning systems, powered by PrepU, answered "A Venturi mask." To provide an oxygen concentration of 70%, a partial rebreathing mask should be used. A Venturi mask provides less than 30% oxygen concentration.

A client with myasthenia gravis is receiving continuous mechanical ventilation. When the high-pressure alarm on the ventilator sounds, what should the nurse do? a) Suction the client's artificial airway. b) Check for an apical pulse. c) Ventilate the client with a handheld mechanical ventilator. d) Increase the oxygen percentage.

Correct response: a) Suction the client's artificial airway. Explanation: A high-pressure alarm on a continuous mechanical ventilator indicates an obstruction in the flow of oxygen from the machine to the client. The nurse should suction the client's artificial airway to remove respiratory secretions that could be causing the obstruction. The sounding of a ventilator alarm has no relationship to the apical pulse. Increasing the oxygen percentage and ventilating with a handheld mechanical ventilator wouldn't correct the airflow blockage. *** note: I chose Ventilate the client with a handheld mechanical ventilator.

Oxygen Delivery Classification

Oxygen delivery systems are classified as either low-flow or high-low systems. Whereas a low-flow oxygen delivery system may imprecisely deliver high concentrations of oxygen (e.g., up to 100% via a nonrebreathing mask), the Venturi mask, which is a highflow system, is specifically designed to deliver precise but lower concentrations of oxygen (e.g., between 24% and 40% oxygen).

A client is receiving supplemental oxygen. When determining the effectiveness of oxygen therapy, which arterial blood gas value is most important? a) Partial pressure of arterial oxygen (PaO2) b) Bicarbonate (HCO3-) c) pH d) Partial pressure of arterial carbon dioxide (PaCO2)

a) Partial pressure of arterial oxygen (PaO2) Explanation: The most significant and direct indicator of the effectiveness of oxygen therapy is the PaO2 value. Based on the PaO2 value, the nurse may adjust the type of oxygen delivery (cannula, Venturi mask, or mechanical ventilator), flow rate, and oxygen percentage. The other options reflect the client's ventilation status, not oxygenation. The pH, HCO3-, and PaCO2 (less) *** note: I chose PaCO2.

A client has a sucking stab wound to the chest. Which action should the nurse take first? a) Draw blood for a hematocrit and hemoglobin level. b) Prepare to start an I.V. line. c) Apply a dressing over the wound and tape it on three sides. d) Prepare a chest tube insertion tray.

c) Apply a dressing over the wound and tape it on three sides. Explanation: The nurse should immediately apply a dressing over the stab wound and tape it on three sides to allow air to escape and to prevent tension pneumothorax (which is more life-threatening than an open chest wound). Only after covering and taping the wound should the nurse draw blood for laboratory tests, assist with chest tube insertion, and start an I.V. line. *** note: I chose prepare a chest tube insertion tray.