You are a veteran Registered Nurse precepting newly graduated nurses in the hospital.
When your preceptee asks what is the benefit of the non-rebreather mask versus a simple mask, what is your BEST reply?
The non-rebreather mask provides the highest FiO2 of oxygen, around 90%.
A non-rebreather provides higher levels of CO2 during respirations.
A simple mask is simpler to operate.
Non-rebreather masks are better for patients with nausea or claustrophobia.
The Correct Answer is A
Choice A rationale
The non-rebreather mask delivers the highest possible fraction of inspired oxygen (FiO2) among conventional oxygen delivery devices, often reaching 85-90%. This high concentration is achieved by a one-way valve system that prevents exhaled air from mixing with the inspired oxygen and a reservoir bag that stores a high concentration of oxygen. This mechanism minimizes room air entrainment, maximizing oxygen delivery to the patient's respiratory system.
Choice B rationale
A non-rebreather mask is designed to deliver high concentrations of oxygen and prevent rebreathing of exhaled gases, including carbon dioxide. The one-way valves direct exhaled air out of the mask, ensuring that the patient inhales nearly pure oxygen from the reservoir bag, thereby minimizing CO2 retention, not increasing it. This physiological effect ensures efficient gas exchange.
Choice C rationale
While a simple mask may appear less complex in its physical design, its operation still requires proper fitting and flow rate adjustment for effective oxygen delivery. The perceived simplicity does not outweigh the significant physiological advantage of a non-rebreather mask in delivering higher oxygen concentrations, which is the primary goal of oxygen therapy.
Choice D rationale
Non-rebreather masks, due to their tight seal and large reservoir bag, can exacerbate feelings of claustrophobia in some patients. Similarly, the mask's design might induce or worsen nausea in individuals prone to it, making simpler face masks or nasal cannulas often more tolerable options for these patient populations. Patient comfort and tolerance are crucial considerations in oxygen therapy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Uncompensated respiratory acidosis would exhibit a low pH (normal range 7.35-7.45) and an elevated PaCO2 (normal range 35-45 mmHg), with a bicarbonate level (normal range 22-26 mEq/L) that remains within the normal range. In this scenario, the bicarbonate is elevated, indicating a renal compensatory response has begun.
Choice B rationale
The patient's pH of 7.3 indicates acidosis (normal 7.35-7.45). The PaCO2 of 68 mmHg is elevated (normal 35-45 mmHg), indicating a respiratory origin. The HCO3 of 28 mmol/L is elevated (normal 22-26 mEq/L), signifying that the kidneys are attempting to compensate by retaining bicarbonate. Since the pH is still acidic, but the bicarbonate is responding, it is partially compensated respiratory acidosis.
Choice C rationale
Metabolic acidosis is characterized by a low pH (normal 7.35-7.45) and a low bicarbonate level (normal 22-26 mEq/L). The PaCO2 (normal 35-45 mmHg) would either be normal if uncompensated or low if the respiratory system was compensating. Here, the primary disturbance is respiratory.
Choice D rationale
Metabolic alkalosis presents with an elevated pH (normal 7.35-7.45) and an elevated bicarbonate level (normal 22-26 mEq/L). The PaCO2 (normal 35-45 mmHg) would be normal if uncompensated or elevated if the respiratory system was compensating. This patient's pH is acidic, ruling out alkalosis.
Correct Answer is D
Explanation
Choice A rationale
Uncompensated respiratory acidosis would display a low pH (normal 7.35-7.45) and an elevated PaCO2 (normal 35-45 mmHg), with the bicarbonate (normal 22-26 mEq/L) remaining within the normal range. This patient's PaCO2 is low, and the primary issue is metabolic, not respiratory.
Choice B rationale
Partially compensated respiratory acidosis would show a low pH (normal 7.35-7.45), an elevated PaCO2 (normal 35-45 mmHg), and an elevated bicarbonate (normal 22-26 mEq/L). This patient's PaCO2 is low, and the bicarbonate is significantly low, indicating a metabolic origin.
Choice C rationale
Metabolic alkalosis is characterized by an elevated pH (normal 7.35-7.45) and an elevated bicarbonate level (normal 22-26 mEq/L). This patient has a significantly low pH and bicarbonate, directly contradicting the parameters of metabolic alkalosis.
Choice D rationale
The patient's pH of 7.0 is highly acidic (normal 7.35-7.45). The bicarbonate level of 12 mmol/L is significantly low (normal 22-26 mEq/L), indicating a primary metabolic acidosis. The PaCO2 of 23 mm Hg is low (normal 35-45 mmHg), demonstrating respiratory compensation through Kussmaul breathing. The pH is still acidic, showing partial compensation.
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