A nurse is caring for a patient who has a tracheostomy and is receiving oxygen therapy via tracheostomy collar at 40% FiO2. The nurse should ensure that which of the following is in place to prevent complications?

Choice A rationale:

The nurse should instruct the patient to avoid smoking or being near open flames while using oxygen. Oxygen supports combustion, and smoking or exposure to flames can lead to a fire hazard.

Choice C rationale:

Checking the position of the oxygen delivery device frequently is important to ensure proper oxygen delivery and avoid any displacement or obstruction that may compromise the therapy's effectiveness.

Choice D rationale:

Instructing the patient to report any signs of hypoxia (low oxygen levels) or hypercarbia (high carbon dioxide levels) to the provider is crucial for early detection of potential complications and appropriate management.

Choice E rationale:

Instructing the patient to adjust the flow rate of oxygen as needed allows them to respond to varying oxygen requirements, especially during activities or changes in their respiratory condition.

Choice B rationale:

Using cotton or wool clothing and bedding is not a recommended instruction for oxygen therapy. Synthetic materials are preferred as they are less likely to catch fire compared to cotton or wool.

Choice D rationale:

The nurse should connect the nasal cannula to a humidifier first. Dry and irritated nares are common side effects of oxygen therapy via nasal cannula, and using a humidifier adds moisture to the oxygen, reducing irritation and discomfort for the patient.

Choice A rationale:

Applying petroleum jelly to the nares is not the first action to take. It might provide temporary relief, but it is essential to address the root cause of dryness, which is the lack of moisture in the oxygen delivered.

Choice B rationale:

Increasing the flow rate of oxygen is not the first step because it may not address the dryness issue. It can lead to a higher concentration of oxygen, but it won't solve the problem of dry and irritated nares.

Choice C rationale:

Changing the nasal cannula to a face mask is not necessary to address the dryness. Face masks may not be well-tolerated by some patients, and it's better to try less invasive interventions first.