Highest oxygen concentration will be delivered by?

RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Nursing Foundation

Easy

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

The partial non-rebreather mask is a reservoir system designed for high-concentration oxygen delivery.
It can deliver an FiO2 (fraction of inspired oxygen) of approximately 50% to 75%.
The attached reservoir bag allows the patient to rebreathe the first third of their exhaled air, which is rich in oxygen, thus increasing the overall inspired oxygen concentration.
This FiO2 is significantly higher than that delivered by nasal cannulas, nasal catheters, or simple face masks.

Option A: A nasal catheter is a low-flow device that delivers a relatively low oxygen concentration, typically similar to or slightly less effective than a nasal cannula, as it is more invasive and less comfortable.
Option B: A nasal cannula is a low-flow device that delivers an FiO2 of only 24% to 44% at flow rates of 1 to 6 L/min. This is much lower than a partial rebreather mask.
Option D: A simple O2 mask delivers a moderate FiO2 of 40% to 60% at flow rates of 5 to 8 L/min. While higher than a nasal cannula, it is lower than a partial rebreather mask.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Oxygen Delivery Devices and FiO2 as background academic context rather than a clinical decision trigger.
Selecting the appropriate oxygen delivery device is a critical nursing skill that directly impacts patient oxygenation and safety.
A key nursing intervention for reservoir masks (partial and non-rebreather) is to ensure the reservoir bag remains at least two-thirds inflated during inspiration. A collapsing bag indicates the flow rate is too low.
What if the patient's oxygen saturation does not improve on a partial rebreather mask? The nurse should assess for mask leakage, ensure the flow rate is adequate, and prepare to escalate to a non-rebreather mask or notify the provider for potential non-invasive or invasive ventilation.

How to Approach the Question

First, identify the core of the question, which is to find the device that delivers the 'highest' oxygen concentration.
Recall the different types of oxygen delivery systems and categorize them as low-flow or high-flow/reservoir systems.
Compare the maximum FiO2 (fraction of inspired oxygen) delivered by each option: Nasal catheter/cannula (low), Simple mask (moderate), and Partial non-rebreather mask (high).
Recognize that reservoir masks (like the partial rebreather) are specifically designed to deliver higher oxygen concentrations than non-reservoir systems.
Based on this comparison, conclude that the partial non-rebreather mask provides the highest FiO2 among the choices.

Concept Tested & Keywords

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