Chapter 7: Oxygen Therapy Management

What are the two categories of oxygen delivery systems?

Low-flow and high-flow systems.

What is the FiO₂ range delivered by a nasal cannula?

Approximately 24–44%, depending on flow rate.

What are the indications for using a nasal cannula?

First-line for mild hypoxemia and comfortable for chronic therapy.

List one advantage and disadvantage of a nasal cannula.

Advantage: Simple and inexpensive; Disadvantage: FiO₂ varies with breathing pattern.

What is the recommended flow rate at which humidification should be added to a nasal cannula?

Humidification should be added for flows greater than 4 L/min.

What type of mask is used to deliver higher O₂ concentrations of about 40–60%?

Simple face mask.

What is a potential drawback of using a simple face mask?

Interferes with eating and speaking.

What device delivers the highest concentration of O₂ without intubation?

Non-rebreather mask (NRB).

What is the minimum flow rate required for a non-rebreather mask to be effective?

At least 10–15 L/min.

What should be done if the reservoir bag on a non-rebreather mask collapses completely during inspiration?

Increase the oxygen flow rate.

For which condition is a Venturi mask particularly useful?

Patients with COPD and CO₂ retention.

What is the advantage of using a Venturi mask?

Delivers precise FiO₂ regardless of breathing pattern.

What is the FiO₂ range that can be achieved with a high-flow nasal cannula (HFNC)?

21% to 100% FiO₂.

Why is HFNC preferred for patients with respiratory failure?

It provides high flow, warmed and humidified O₂, aiding oxygenation.

What should be monitored closely in a patient on CPAP?

The seal of the mask and oxygen saturation levels.

What is the primary indication for using BiPAP?

Hypercapnic respiratory failure.

What should a nurse monitor in a COPD patient receiving supplemental O₂?

Signs of CO₂ retention, such as lethargy and decreased respiratory rate.

In which situation is oxygen therapy considered a medication?

When managing hypoxemia in a patient.

What are the target SpO₂ levels for patients with chronic lung diseases?

88-92%.

What is the nursing consideration regarding oxygen therapy for patients with CO₂ retention?

Titrate oxygen carefully to avoid knocking out their drive to breathe.

What is the recommended oxygen therapy for a patient with signs of hypoxia?

Supplemental O₂ to maintain adequate tissue oxygenation.

What is a sign that indicates the need for oxygen therapy in patients with cardiac conditions?

Signs of low oxygen saturation, such as SpO₂ < 90-92%.

What complication can occur from prolonged oxygen therapy?

Oxygen toxicity.

What is absorption atelectasis associated with?

High concentrations of O₂ replacing nitrogen in the alveoli.

What monitoring should be done when a patient is receiving oxygen therapy?

Monitor respiratory status and oxygen saturation levels.

How should a nurse respond if a patient's ABG results show respiratory acidosis?

Evaluate oxygen levels and assist with ventilation if necessary.

What is the purpose of bronchodilators in respiratory therapy?

To relax bronchial smooth muscles and widen airways.

What should a nurse assess before administering bronchodilators?

Breath sounds and heart rate.

What are the indications for using corticosteroids in respiratory conditions?

To reduce airway inflammation.

What side effects should be monitored when a patient is on glucocorticoids?

Hyperglycemia and signs of infection.

What should be done to maintain hydration for patients on mucolytics?

Encourage oral fluid intake.

What is key to preventing oxygen-associated mucosal irritation?

Using humidification for oxygen delivered at high flow rates.

What positioning aids oxygenation for patients in respiratory distress?

High Fowler's position.

What activity should patients with COPD be taught to help with dyspnea?

Pursed-lip breathing.

What action should a nurse take for a patient displaying early signs of hypoxemia?

Administer supplemental oxygen.

What is one non-pharmacological intervention to aid in oxygenation?

Incentive spirometry to encourage deep breaths.

What type of monitoring is crucial for patients receiving BiPAP?

Continuous monitoring of respiratory status and gas exchange.

What is the priority action for a patient with a respiratory rate of 8 and SpO₂ of 89% on oxygen?

Arouse the patient and encourage deep breathing.

What should patients using home oxygen be informed to avoid due to fire risks?

Smoking and open flames.

What is the importance of teaching patients about using their oxygen equipment?

Ensures they know how to use and maintain their oxygen in the home.

What is critical in maintaining the functional capacity of nebulized medications?

Ensuring sufficient oxygen flow during nebulization.

What should be reported immediately if a patient on oxygen shows sudden changes in mental status?

Possible signs of hypoxia or CO₂ retention.

How often should the effectiveness of oxygen therapy be evaluated?

Continuously, especially after any adjustment in therapy.

What does a significant change in a patient’s PaO₂ and SpO₂ indicate?

The need for reassessment of oxygen therapy.

What should patients be taught regarding the administration of high-flow oxygen?

Use humidification to prevent mucosal drying.

What physiological change can indicate oxygen toxicity in patients on high-flow oxygen therapy?

Developing new-onset dyspnea or chest pain.

What is the rationale for using a Venturi mask with color-coded adapters?

To deliver a precise and controlled FiO₂ level.