Medical Surgical Ventilator Settings & Mechanical Ventilation #3

Question

The nurse is caring for a client in the intensive care unit who has been on a ventilator set on 80% FiO2 for three days. The nurse will observe the client for risk of having which condition as a result of prolonged ventilator settings with 80% FiO2?

Answers

  1. Pulmonary fibrosis.
    • Rationale:

      This answer is correct because pulmonary fibrosis and oxygen toxicity are the highest risks for a client on a ventilator with high levels of FiO2 for more than 72 hours.

  2. Pleural effusion.
    • Rationale:

      This answer is not correct because pleural effusion would not occur as a direct result of exposure to high amounts of FiO2. Pleural effusion may be a reason for intubation and mechanical ventilation however, oxygen toxicity does not directly cause pleural effusion.

  3. Pneumonia.
    • Rationale:

      This answer is not correct because pneumonia would not occur as a direct result of exposure to high amounts of FiO2. Pneumonia may be a reason for intubation and mechanical ventilation however, oxygen toxicity does not directly cause pleural effusion.

  4. Legionnaires Disease.
    • Rationale:

      This answer is not correct because Legionnaire’s disease is caused by legionella, and by contraction of the bacterium known as legionella pneumophila. This infection does not result directly from prolonged exposure to high amounts of oxygen.

Overview

The focus of this question is determining which potential complication occurs as a result of prolonged exposure to high amounts of FiO2. Oxygen toxicity may occur after several days of high amounts of FiO2 leading to collagen deposition and thickening of the pulmonary interstitial space, eventually resulting in scarring and pulmonary fibrosis.

Explanation

Learning Outcomes

Oxygen toxicity is a condition that results from the harmful effects of excessive oxygen at increased partial pressures. This client is at high risk for oxygen toxicity due to delivery of 80% FiO2 for three days. Oxygen toxicity can lead to the deposition of excess collagen and thickening of the interstitial pulmonary space causing pulmonary fibrosis. The nurse should monitor for signs of oxygen toxicity, including excess coughing in all clients receiving high amounts of oxygen for prolonged periods.

Test Taking Tip

Answer choices # 3 & 4 are both infections so both can be ruled out as options, leaving answer choices #1 & 2. By process of elimination, pleural effusion may be ruled out because pleural effusion by definition is an excess of fluid within the pleural space which is normally caused by some form of fluid volume overload.

Video Rationale