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 ["C","D"]
Explanation
Choice A rationale
Patient self-extubation would typically trigger a low-pressure alarm, not a high-pressure alarm, because the ventilator circuit would no longer be connected to the patient's airway, resulting in a sudden drop in airway pressure and a loss of positive pressure ventilation.
Choice B rationale
Disconnection of the tubes, similar to self-extubation, would lead to a low-pressure alarm due to the loss of a closed circuit. The ventilator would detect a rapid decrease in pressure within the system as air escapes, indicating a leak or complete disconnection.
Choice C rationale
Tube displacement, particularly if the endotracheal tube is pushed deeper into the bronchus or becomes kinked, increases airway resistance. This heightened resistance requires the ventilator to exert more pressure to deliver the set tidal volume, thus triggering a high-pressure alarm.
Choice D rationale
The patient biting the endotracheal (ET) tube creates an occlusion within the airway, significantly increasing airway resistance. This increased resistance makes it harder for the ventilator to deliver breaths, leading to a rapid rise in peak inspiratory pressure and activating the high-pressure alarm.
Correct Answer is ["B","C","E"]
Explanation
Choice A rationale
Encouraging extensive family visitation in the context of impending demise, while emotionally supportive, does not directly address the physiological mechanisms of intracranial pressure reduction. Increased stimulation and emotional distress can paradoxically elevate ICP by increasing cerebral metabolic demand and blood flow, which is counterproductive to managing an acute neurological crisis.
Choice B rationale
Maintaining the patient's neck in a midline and neutral position is crucial to facilitate optimal venous outflow from the brain. Compression or kinking of the jugular veins due to neck rotation or flexion can impede cerebral venous drainage, leading to an increase in cerebral blood volume and subsequently elevated intracranial pressure.
Choice C rationale
Administering stool softeners helps prevent straining during defecation, a maneuver known as the Valsalva maneuver. The Valsalva maneuver increases intrathoracic and intra-abdominal pressure, which in turn transiently increases central venous pressure and impedes cerebral venous outflow, thereby elevating intracranial pressure.
Choice D rationale
Keeping room curtains open to maximize natural light can increase environmental stimulation, potentially leading to increased cerebral activity and metabolic demand. This heightened activity can result in increased cerebral blood flow and volume, which can contribute to elevated intracranial pressure in a neurologically compromised patient.
Choice E rationale
Elevating the head of the bed (HOB) to 30 degrees promotes venous drainage from the brain by utilizing gravity. This position helps to reduce cerebral blood volume, thereby decreasing intracranial pressure. It also aids in preventing aspiration while maintaining cerebral perfusion pressure.
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