A nurse is assessing a client who has recently started supplemental oxygen therapy. Which signs indicate that the therapy is ineffective? (Select all that apply)

Choice A reason: Palliative surgery prioritizes symptom relief, not diagnostic data collection. Procedures like biopsies aim to gather information for medical planning, not alleviate symptoms. Palliative surgery addresses issues like pain or obstruction in terminal conditions, improving quality of life without curing, making this choice incorrect for palliative rationale.

Choice B reason: Elective procedures for improving body structures, like cosmetic surgery, are not palliative. Palliative surgery focuses on symptom relief in serious illnesses, not aesthetic enhancements. This choice is irrelevant, as palliative care aims to manage symptoms like pain or obstruction, not improve physical appearance or structure.

Choice C reason: Repairing deformities from birth or disease is linked to reconstructive surgery, not palliative care. Palliative surgery relieves symptoms like pain or obstruction without addressing the underlying cause, unlike corrective procedures, making this choice inappropriate for the rationale of a palliative surgical procedure.

Choice D reason: Palliative surgery relieves symptoms, such as pain or obstruction, in conditions where a cure is not feasible, like terminal cancer. It focuses on improving quality of life, not curing the disease, making this the most appropriate rationale for a palliative surgical procedure in the preoperative context.

Choice A reason: Anxiety and restlessness indicate ineffective oxygen therapy, as they suggest persistent hypoxia or hypercapnia. The brain senses inadequate oxygenation, triggering a stress response, indicating the need for adjusted oxygen delivery or investigation into underlying respiratory issues, making this a sign of therapy failure.

Choice B reason: Pink, warm skin indicates adequate oxygenation and perfusion, suggesting effective oxygen therapy. Cyanosis or cool skin would signal hypoxia. This finding reflects successful correction of oxygen deficits, making it an incorrect choice for indicating ineffective therapy in this client with supplemental oxygen.

Choice C reason: A heart rate of 58 (bradycardia) is not a primary indicator of ineffective oxygen therapy. Severe hypoxia typically causes tachycardia, while bradycardia may reflect other issues like medication effects, not directly oxygen therapy failure, making it less relevant in this context.

Choice D reason: A respiratory rate of 36 (tachypnea) indicates ineffective oxygen therapy, as rapid breathing reflects the body’s attempt to compensate for hypoxia or hypercapnia. This suggests insufficient oxygen delivery, requiring adjustment of oxygen flow or evaluation for respiratory issues, marking therapy failure.

Choice E reason: Use of accessory muscles indicates ineffective oxygen therapy, reflecting increased work of breathing due to persistent hypoxia or airway obstruction. Muscles like the sternocleidomastoid are recruited when primary respiratory muscles fail to maintain adequate oxygenation, signaling the need for immediate intervention.