Your patient's wife reports that the patient snores loudly all night, and has long periods of not taking breaths. The doctor diagnoses the patient with Obstructive Sleep Apnea.
Which of the following oxygen delivery systems would be MOST appropriate for the patient to use at home to help his condition?
Venturi Mask.
CPAP.
Nasal Cannula.
BiPAP.
The Correct Answer is B
Choice A rationale
A Venturi mask delivers a precise, fixed concentration of oxygen by mixing oxygen with a set amount of room air. While useful for controlled oxygen delivery in acute settings, it is not the most appropriate long-term home therapy for obstructive sleep apnea, which primarily requires continuous positive airway pressure to maintain airway patency.
Choice B rationale
Continuous Positive Airway Pressure (CPAP) is the gold standard for treating obstructive sleep apnea. It delivers a constant stream of positive pressure air, which acts as a pneumatic splint to keep the upper airway open during sleep, preventing episodes of apnea and hypopnea by maintaining pharyngeal patency.
Choice C rationale
A nasal cannula delivers low-flow oxygen and is generally used for mild hypoxemia. It does not provide the positive pressure needed to keep the airway open during sleep, making it ineffective for treating the underlying airway collapse characteristic of obstructive sleep apnea. It does not address the mechanical obstruction.
Choice D rationale
Bi-level Positive Airway Pressure (BiPAP) delivers different pressures for inspiration and expiration. While also used for sleep apnea, CPAP is typically the first-line and simpler option. BiPAP is often reserved for patients who cannot tolerate CPAP or have coexisting respiratory conditions requiring more sophisticated pressure support, or central apnea.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Diabetes mellitus is a metabolic disorder characterized by hyperglycemia resulting from defects in insulin secretion, insulin action, or both. It typically presents with polyuria, polydipsia, and polyphagia, which contrasts with the patient's current presentation of decreased urine output and hyponatremia. The underlying pathophysiology involves pancreatic beta cell dysfunction or insulin resistance, not directly related to brain tumor removal.
Choice B rationale
Hypertonic agonism is not a recognized medical term or complication. The concept of tonicity relates to the osmotic pressure of a solution, and an "agonist" refers to a substance that binds to a receptor and initiates a physiological response. This option does not align with the patient's symptoms of decreased urine output and hyponatremia following brain surgery.
Choice C rationale
Diabetes insipidus (DI) is a condition characterized by the inability of the kidneys to conserve water, leading to excessive urination (polyuria) and thirst (polydipsia). This is often due to insufficient production of antidiuretic hormone (ADH) or renal insensitivity to ADH. The patient's presentation of *decreased* urine output directly contradicts the hallmark symptom of DI.
Choice D rationale
Syndrome of inappropriate antidiuretic hormone (SIADH) is characterized by excessive secretion of ADH, leading to water retention, dilutional hyponatremia (serum sodium 124 mEq/L, normal range 135-145 mEq/L), and decreased urine output. Brain surgery can stimulate ADH release. This aligns with the patient's symptoms of decreased urine output and low serum sodium.
Correct Answer is B
Explanation
Choice A rationale
Respiratory acidosis is characterized by a low pH and an elevated PaCO2. The patient's pH is elevated (7.61), indicating alkalosis, and the PaCO2 is low (22 mmHg). These findings are the opposite of what would be seen in respiratory acidosis.
Choice B rationale
The pH of 7.61 is significantly elevated, indicating alkalosis. The PaCO2 of 22 mmHg is markedly decreased below the normal range (35-45 mmHg). This decrease in carbon dioxide, a potent acid, directly causes the alkalosis. The bicarbonate (HCO3) level of 25 mEq/L is within the normal range (22-26 mEq/L), indicating that the renal system has not yet initiated any compensatory response. Therefore, this pattern is consistent with uncompensated respiratory alkalosis, primarily driven by hyperventilation.
Choice C rationale
Metabolic alkalosis would present with an elevated pH and an elevated bicarbonate level. While the pH is elevated, the bicarbonate (25 mEq/L) is within the normal range, and the PaCO2 is low, which is inconsistent with metabolic alkalosis as the primary imbalance.
Choice D rationale
Metabolic acidosis is characterized by a low pH and a low bicarbonate level. The patient's pH is high (alkalotic) and the bicarbonate is normal. This contradicts the diagnostic criteria for metabolic acidosis.
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