Medical Surgical Oxygen Delivery & Hypoxemia #4

Question

The nurse is caring for a client with Duchene multiple dystrophy who suffers from nocturnal desaturation. Which oxygen delivery system would promote gas exchange and best reduce high levels of CO2 during sleep?

Answers

  1. Non-Rebreather mask
    • Rationale:

      This answer is not correct because the non-rebreather is used in medical emergency situations. Although, this mask will increase oxygen levels and help decrease CO2.

  2. Venturi mask
    • Rationale:

      This answer is not correct because although it offers precise oxygen delivery, it is not the best choice for oxygen delivery in a client with a neuromuscular disease experiencing hypoventilation during sleep. The Venturi mask is usually used in clients with unstable COPD.

  3. BiPAP
    • Rationale:

      This answer is correct because BiPAP is best in reducing hypercapnia. In a client with neuromuscular disease symptoms which are related to hypercapnia, diurnal respiratory failure often follows. This is a major cause of morbidity for these clients. BiPAP forcefully pushes air deep into the lungs to reduce CO2 levels.

  4. Intubation
    • Rationale:

      This answer is not correct because intubation is the ultimate solution to keep the airway patent. It is used during surgery or as a last effort to compromise the airway.

Overview

Nocturnal desaturation is a temporary drop in oxygen levels during sleep. This is common in clients with neuromuscular diseases or clients with COPD.

Explanation

Learning Outcomes

Nocturnal desaturation is a temporary drop in oxygen levels during sleep. This is common in clients with neuromuscular diseases where there is respiratory muscle weakness. Symptoms which are related to hypercapnia, diurnal respiratory failure often follows in these clients. This is a major cause of death. BiPAP forcefully pushes air deep into the lungs to reduce CO2 levels. The non-rebreather mask will increase oxygen levels and decrease CO2, but is typically used in medical emergency situations. The Venturi mask is used in clients with unstable COPD. Intubation is the last resort when the airway is compromised.

Test Taking Tip

Remember if “hypercap” give “BiPAP”.

Video Rationale