A nurse is assessing a patient who has been using a nasal cannula for oxygen therapy. The patient complains of nasal dryness and irritation. What intervention should the nurse implement?
Switch to a simple face mask for better oxygen delivery.
Increase the flow rate of oxygen to improve humidity.
Assess the patient's nares for patency and skin integrity.
Reassure the patient that nasal dryness is a normal side effect.
The Correct Answer is C
Choice A rationale:
Switching to a simple face mask is not the appropriate intervention for nasal dryness and irritation. A simple face mask covers the nose and mouth, and it may not provide enough relief for nasal dryness as the oxygen flow is still directed towards the nose.
Choice B rationale:
Increasing the flow rate of oxygen will not directly improve humidity. Nasal dryness and irritation are often caused by the lack of moisture in the delivered oxygen. Increasing the flow rate may worsen the issue.
Choice C rationale:
Assessing the patient's nares for patency and skin integrity is the appropriate intervention. Nasal dryness and irritation can be caused by inadequate humidification of the oxygen. Checking the patency of the nares and the condition of the skin can help identify any issues that may be contributing to the discomfort.
Choice D rationale:
Reassuring the patient that nasal dryness is a normal side effect is not sufficient. While nasal dryness can be a common side effect of using a nasal cannula, it is essential to address the issue and provide appropriate interventions to alleviate the discomfort and prevent complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is choice a. PaO2 80 mmHg.
Choice A rationale:
PaO2 (partial pressure of oxygen in arterial blood) of 80 mmHg indicates that the oxygen therapy has been effective. Normal PaO2 levels range from 75 to 100 mmHg, so a value of 80 mmHg suggests adequate oxygenation.
Choice B rationale:
SaO2 (arterial oxygen saturation) of 88% is below the normal range (typically 95-100%) and indicates hypoxemia, suggesting that the oxygen therapy has not been fully effective.
Choice C rationale:
A respiratory rate (RR) of 32 breaths per minute is significantly higher than the normal range (12-20 breaths per minute) and indicates respiratory distress, suggesting that the oxygen therapy has not been effective.
Choice D rationale:
Blood pressure (BP) of 160/90 mmHg is elevated and indicates hypertension, which is not a direct measure of the effectiveness of oxygen therapy. This finding does not provide information about the patient’s oxygenation status.
Correct Answer is ["A","B","D"]
Explanation
Choice A: Nasal cannula is a low-flow oxygen delivery system. It delivers a variable oxygen concentration depending on the patient's breathing pattern.
Choice B: Simple face mask is also a low-flow oxygen delivery system. It provides a variable oxygen concentration based on the patient's respiratory rate and tidal volume.
Choice C: Venturi mask is not a low-flow system. It is a high-flow oxygen delivery device that provides a fixed oxygen concentration by mixing oxygen with room air.
Choice D: Non-rebreather mask is considered a low-flow oxygen delivery system. It provides a high concentration of oxygen but does not ensure a precise oxygen concentration due to varying patient ventilation.
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