A nurse is applying oxygen via nasal cannula to a client diagnosed with chronic obstructive pulmonary disease (COPD). The client reports extreme shortness of breath. At what rate should the nurse set the flowmeter?
4L of oxygen per minute
2L of oxygen per minute
6L of oxygen per minute
8L of oxygen per minute
The Correct Answer is B
A. Oxygen at 4L per minute is generally too high for clients with COPD. High oxygen concentrations can suppress their hypoxic drive, which is their primary mechanism for breathing.
B. Oxygen at 2L per minute is the appropriate starting rate for clients with COPD. This flow rate provides supplemental oxygen without significantly increasing the risk of suppressing the client’s respiratory drive.
C. Oxygen at 6L per minute is excessive for clients with COPD and can lead to complications such as hypercapnia or respiratory depression.
D. Oxygen at 8L per minute is not recommended for clients with COPD unless specifically ordered in a life-threatening situation, as it can suppress their respiratory drive and worsen their condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
A. Decreased PaO2 <60mmHg: A hallmark of fat embolism syndrome (FES) is hypoxemia, which results in a PaO2 less than 60 mmHg. This is a key indicator of the severity of respiratory compromise in FES and ARDS.
B. PaO2 greater than 80mmHg: This would not be consistent with FES. Fat embolism often causes significant hypoxemia, and PaO2 greater than 80 mmHg would indicate adequate oxygenation.
C. Decreased platelet count and hematocrit levels: In fat embolism syndrome, there is often a decrease in platelet count and hematocrit due to disseminated intravascular coagulation (DIC), which can occur as a complication of fat embolism.
D. Changes in ST segment and T-wave: Electrocardiographic changes, including changes in ST segment and T-wave, are commonly seen in fat embolism syndrome due to myocardial injury, hypoxemia, or shock.
E. PaCO2 40mmHg: A PaCO2 of 40 mmHg is within normal limits and does not indicate any significant respiratory distress or abnormality that would be expected in fat embolism syndrome.
Correct Answer is A
Explanation
A. If there is no fluctuation in the water seal compartment, the first action should be to check for kinks, obstructions, or other issues in the tubing that might block air or fluid movement. Fluctuation (tidaling) is expected during respiration, and its absence may indicate a problem with the system or that the lung has fully re-expanded.
B. Notifying the healthcare provider immediately is not the first step. The nurse should first assess the chest tube system to determine if there is an issue that can be resolved without medical intervention.
C. Increasing the suction pressure on the chest tube is not appropriate without first identifying the cause of the lack of fluctuation. Adjusting suction may not address the underlying problem.
D. Continuing to monitor and reassess in 1 hour delays addressing the potential issue. Immediate assessment of the chest tube system is necessary to ensure proper functioning.
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