Untitled Flashcards Set

Low-Flow Oxygen Delivery Systems

Nasal Cannula

Tubing with two small prongs for insertion into the nares

Fraction of inspired oxygen: Delivers an FiO2 of 24% to 44% at a flow rate of 1 to 6 L/min.

Advantages

  • A cannula is a safe, simple, and easy-to-apply method.

  • A cannula is comfortable and well-tolerated.

  • The client is able to eat, talk, and ambulate.

Disadvantages

  • The FiO2 varies with the flow rate, and the rate and depth of the client’s breathing.

  • Extended use can lead to skin breakdown and dry mucous membranes.

  • Tubing is easily dislodged.​​​​​​​

Nursing Actions

  • Assess the patency of the nares.

  • Ensure that the prongs fit in the nares properly.

  • Use water-soluble gel to prevent dry nares.

  • Provide humidification for flow rates of 4 L/min and greater.

Simple Face Mask

Covers the client’s nose and mouth

Fraction of Inspired Oxygen

  • It delivers an FiO2 of 35% to 60% at flow rates of 5 to 10 L/min.

  • The minimum flow rate is 5 L/min to ensure flushing of CO2 from the mask.

Advantages

  • A face mask is easy to apply and can be more comfortable than a nasal cannula.

  • It is a simple delivery method.

  • It is more comfortable than a nasal cannula.

  • It provides humidified oxygen.

Disadvantages

  • Flow rates less than 5 L/min can result in rebreathing of CO2.

  • Clients who have anxiety or claustrophobia do not tolerate it well.

  • Eating, drinking, and talking are impaired.

  • Moisture and pressure can collect under the mask and cause skin breakdown.

  • Face masks pose a greater risk of aspiration.

Nursing Actions

  • Assess proper fit to ensure a secure seal over the nose and mouth.

  • Make sure the client wears a nasal cannula during meals.

  • Use with caution for clients who have a high risk of aspiration or airway obstruction. 

  • Monitor for skin breakdown.

Partial Rebreather Mask

Covers the client’s nose and mouth

Fraction of inspired oxygen: Delivers an FiO2 of 60% to 90% at flow rates of 10 to 15 L/min.

Advantages

  • The mask has a reservoir bag attached with no valve, which allows the client to rebreathe up to ⅓ of exhaled air together with room air.

  • Allows easier humidification of oxygen.

Disadvantages

  • Complete deflation of the reservoir bag during inspiration causes CO2 buildup.

  • The FiO2 varies with the client’s breathing pattern.

  • Clients who have anxiety or claustrophobia do not tolerate it well.

  • Eating, drinking, and talking are impaired.

  • The bag can twist or kink easily.

Nursing Actions

  • Keep the reservoir bag from deflating by adjusting the oxygen flow rate to keep the reservoir bag ⅓ to ½ full on inspiration.

  • Assess proper fit to ensure a secure seal over nose and mouth. Assess for skin breakdown beneath the edges of the mask and bridge of the nose.

  • Make sure the client uses a nasal cannula during meals.

  • Use with caution for clients who have a high risk of aspiration or airway obstruction.

Non-rebreather Mask​​​​​​​

Covers the client’s nose and mouth

Fraction of inspired oxygen: Delivers an FiO2 of 80% to 95% at flow rates of 10 to 15 L/min to keep the reservoir bag ⅔ full during inspiration and expiration.

Advantages

  • It delivers the highest O2 concentration possible (except for intubation).

  • A one-way valve situated between the mask and reservoir allows the client to inhale maximum O2 from the reservoir bag. The two exhalation ports have flaps covering them that prevent room air from entering the mask.

Disadvantages

  • The valve and flap on the mask must be intact and functional during each breath.

  • It is poorly tolerated by clients who have anxiety or claustrophobia.

  • Eating, drinking, and talking are impaired.

  • Use with caution for clients who have a high risk of aspiration or airway obstruction.

Nursing Actions

  • Perform an hourly assessment of the valve and flap.

  • Assess proper fit to ensure a secure seal over the nose and mouth. Assess for skin breakdown beneath the edges of the mask and bridge of nose.

  • Make sure the client uses a nasal cannula during meals.

High-Flow Oxygen Delivery Systems

Venturi Mask

Covers the client’s nose and mouth

Fraction of inspired oxygen: Delivers an FiO2 of 24% to 60% at flow rates of 4 to 15 L/min via different size adapters, which allows specific amounts of air to mix with oxygen.

Advantages

  • It delivers the most precise oxygen concentration with humidity added.

  • Best for clients who have chronic lung disease.

Disadvantages

  • Use is expensive.

  • Eating, drinking, and talking are impaired.

  • The mask and added humidity can lead to skin breakdown.

Nursing Actions

  • Assess frequently to ensure an accurate flow rate.

  • Assess proper fit to ensure a secure seal over the nose and mouth. Assess for skin breakdown beneath the edges of the mask, particularly on the nares.

  • Make sure the tubing is free of kinks.

  • Ensure that the client wears a nasal cannula during meals.

Aerosol Mask

Face tent: fits loosely around the face and neck

Tracheostomy collar: a small mask that covers the surgically created opening of the trachea

Fraction of Inspired Oxygen

  • Delivers an FiO2 of 24% to 100% at flow rates of at least 10 L/min.

  • Provides high humidification with oxygen delivery.

Advantages

  • Use with clients who do not tolerate masks well.

  • Useful for clients who have facial trauma, burns, and thick secretions.

Disadvantages: High humidification requires frequent monitoring.

Nursing Actions

  • Empty condensation from the tubing often.

  • Ensure adequate water in the humidification canister.

  • Ensure that the aerosol mist leaves from the vents during inspiration and expiration

  • Make sure the tubing does not pull on the tracheostomy.