Medical Surgical Oxygen Delivery & Hypoxemia #1

Question

The nurse is caring for a client brought in for carbon monoxide poisoning. The nurse notices the client’s reservoir bag on the non-rebreather mask deflates on inspiration. Which action by the nurse is best?

Answers

  1. Increase the flow of oxygen.
    • Rationale:

      This answer is correct because by increasing the flow of oxygen, the reservoir bag inflates. This increases the amount of oxygen the client inhales. Keeping the reservoir bag more than half way full helps eliminate CO2 and treat the hypoxia.

  2. Open the flutter valve.
    • Rationale:

      This answer is not correct because opening the flutter valve will prevent more oxygen from entering into the mask on inhalation. The flutter valve should stay closed to ensure the client inhales a sufficient amount of oxygen.

  3. Tighten the facemask straps.
    • Rationale:

      This answer is not correct because tightening the facemask straps will not promote ventilation if the reservoir bag is deflated during inhalation. Tightening the mask helps reduce leaks directly but does not increase the reservoir bag.

  4. Replace with a new non-rebreather mask.
    • Rationale:

      This answer is not correct because a new non-rebreather mask is not needed. The oxygen just needs to be increased.

Overview

The client brought in for carbon monoxide poisoning has high carbon dioxide levels and requires more oxygen. A non-rebreather mask is used to facilitate more oxygen inhalation during inspiration. It is used during a medical emergency. The non-rebreather helps eliminate the CO2 and treat the hypoxia. The bag has to be more than halfway full to ensure adequate ventilation. Flutter valve needs to stay closed to help more oxygen enter the mask during inhalation.

Explanation

Learning Outcomes

Carbon monoxide poisoning is treated with administration of oxygen. Carbon monoxide increases carbon dioxide levels. A non-rebreather mask is used to facilitate more oxygen inhalation during inspiration. Non-rebreather masks are used during a medical emergency because they deliver 10-15 liters of oxygen and help eliminate the carbon dioxide. The bag has to be more than halfway full to ensure adequate ventilation. Flutter valve needs to stay closed to help more oxygen get in the mask during inhalation. Tightening the facemask straps will help prevent leaks.

Test Taking Tip

Understand the differences between each type of mask that delivers oxygen. Remember that flutter valves should remain closed to help more oxygen enter “in” during “inhalation”.

Video Rationale