Oxygen Delivery Systems

Question 1

Different Types of Oxygen Delivery Systems

Answer 1

• Nasal Cannula
• Simple Face Mask
• Partial Rebreather Mask
• Non-rebreather Mask
• Venturi Mask
• Face Tent
• Tracheostomy Collar
• T-piece

Question 2

Nasal Cannula: Discussion

Answer 2

• relatively comfortable
• patients can eat, talk, and cough with a nasal cannula in place
• works best if the patient breathes through his nose

Question 3

Nasal Cannula: Fio2

Answer 3

1 L/min= 24%
2 L/min= 28%
3 L/min= 32%
4 L/min= 36%
5 L/min= 40%
6 L/min= 44%

Question 4

Nasal Cannula: Nursing Responsibilities

Answer 4

• check frequently that the prongs are in the patient’s nose
• assess for dryness of the nasal mucosa
• humidity flow at rates above 3 L/min (flow rates > 3L/min) are drying
• encourage the patient to take slow, deep breaths, so he will inhale more oxygen and less room air

Question 5

Simple Face Mask: Discussion

Answer 5

a clear, flexible mask that covers the nose and mouth and delivers oxygen flow into the mask

• requires flow rates greater than 5 L/min to prevent accumulation and rebreathing of exhaled CO2 from within the mask
• masks are not easily tolerated because they fit rightly and keep heat from radiating from the face, making patients feel hot
• talking is muffled, and it must be removed for patient to eat or drink

Question 6

Simple Face Mask: Fio2

Answer 6

5-10 L/min= 40%-60% Fio2

Question 7

Simple Face Mask: Nursing Responsibilities

Answer 7

• place face mask securely over the mouth and nose
• elastic straps fit around the head to hold the mask in place. place straps well above the ears to prevent skin irritation and breakdown
• place gauze or other soft material beneath the straps to prevent irritation
• check the skin around the mask frequently
• check the skin over the ears where the mask strap rubs
• encourage patient to take slow, deep breaths, so he will inhale more oxygen and less room air

Question 8

Partial Rebreather Mask: Discussion

Answer 8

uses the reservoir bag to capture some exhaled gas for rebreathing

• allows higher Fio2 levels to be delivered because O2 is collected in the reservoir bag for inhalation
• exhalation ports allow most exhaled air to escape
• several types are available
• can deliver Fio2 above 50% at flow rates of 6-15 L/min
• patient rebreathes some exhaled air along with O2

Question 9

Partial Rebreather Mask: Fio2

Answer 9

6-15 L/min= 50-90% Fio2

Question 10

Partial Rebreather Mask: Nursing Responsibilities

Answer 10

• maintain the flow at a high enough rate to prevent the reservoir bag from collapsing during inhalation (6-15 L/min)
• encourage patient to take slow, deep breaths, so he will inhale more oxygen and less room air

Question 11

Non-rebreather Mask: Discussion

Answer 11

a type of reservoir bag; a valve keeps exhaled air from entering the reservoir bag

• contains only O2 which allows higher Fio2 delivery
• an Fio2 of 60-100% can be delivered at rates of 6-15 L/min
• the mask is the only external device capable of delivering an Fio2 of 100%

Question 12

Non-rebreather Mask: Fio2

Answer 12

-6-15 L/min= 70%-100% Fio2

Question 13

Non-Rebreather Mask: Nursing Responsibilities

Answer 13

• maintain flow at a rate high enough to keep the reservoir at least one third to one-half full during inhalation
• be sure the mask fits snugly so the patient will breathe in less room air

Question 14

Venturi Mask: Discussion

Answer 14

a cone-shaped adapter that serves as a mixing valve to control the amount of O2 and room air that flows through the mask

• the cone shaped adapter at the base of the mask allows a precise Fio2 to be delivered; useful for patients with chronic lung disease
• exhalation ports keep CO2 buildup to a minumum

Question 15

Venturi Mask: Fio2

Answer 15

24%-50% Fio2

Question 16

Venturi Mask: Nursing Responsibilities

Answer 16

the adapter indicates the required oxygen flow rate needed to deliver the desired Fio2
-ensure that flow is set at the rate specified to deliver the Fio2 desired

Question 17

Face Tent: Discussion

Answer 17

a large, open plastic mask that fits under the chin. It is open at the top and is held in place with an elastic band around the head

• less reliable than a face mask for delivering precise Fio2 levels
• allows moderate -to high- density aerosol delivery for humidification
• patients who feel claustrophobic in a face mask often tolerate a face tent

Question 18

Face Tent: Fio2

Answer 18

8-12 L/min= 30%-55% Fio2

Question 19

Face Tent: Nursing Responsibilities

Answer 19

check the skin over the ears where the mask strap rubs

Question 20

Tracheostomy Collar: Discussion

Answer 20

a small, cup-shaped device that fits over the tracheostomy opening and is held in place with elastic straps around the neck

• it is possible to deliver both high Fio2 and high humidity with a tracheostomy collar
• large-bore tubing is used to deliver humidification to the trachea; however, water frequently condenses inside the tubing and can be accidentally drained into the tracheostomy
• usually a water trap of some sort is placed in the tubing to prevent this problem

Question 21

Tracheostomy Collar: Fio2

Answer 21

4-10 L/min= 24-100%

Question 22

Tracheostomy Collar: Nursing Responsibilities

Answer 22

watch for water accumulation in the tubing

Question 23

T-piece: Discussion

Answer 23

a T-shaped plastic piece; the bottom of the T fits directly and tightly onto the tracheostomy tube
-oxygen and humidity are delivered into one side of the T and exhaled through the other side

Question 24

T-piece: Fio2

Answer 24

4-10 L/min= 24-100%

Question 25

T-piece: Nursing Responsibilities

Answer 25

take care that the oxygen delivery tubing does not pull on the T-piece, which can dislodge the tracheostomy tube and create an airway emergency