Oxygen administration through nasal cannula?

Appeared in: IGIMS Staff Nurse - 2018

Explanation

A nasal cannula is a low-flow oxygen delivery device.
The standard and most common flow rate for a nasal cannula is 1–6 litres per minute (L/min).
This flow rate delivers an oxygen concentration (FiO₂) of approximately 24% to 44%.
Flow rates above this range are not recommended for a standard nasal cannula as they can cause nasal dryness and irritation without significantly increasing the FiO₂.

Option A: The range of 2–4 L/min is within the correct range for a nasal cannula, but it is not the complete range. The standard accepted range extends from 1 L/min up to 6 L/min.
Option C: A flow rate of 6–8 L/min is too high for a standard nasal cannula. It can cause significant nasal mucosal irritation and does not provide a reliable increase in FiO₂. This flow rate is more appropriate for a simple face mask.
Option D: A flow rate of 8–10 L/min is well above the recommended limit for a nasal cannula. This high flow would be very uncomfortable and drying for the patient. Such flow rates are used for devices like simple face masks or partial rebreather masks.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Oxygen delivery via nasal cannula as background academic context rather than a clinical decision trigger.
For a nurse, selecting the correct oxygen delivery device and flow rate is a fundamental skill to ensure patient safety and therapeutic effectiveness.
It is crucial to monitor for signs of nasal dryness, irritation, or skin breakdown around the ears and nares when a patient is on a nasal cannula for an extended period. Humidification should be added for flows greater than 4 L/min.
What if the patient's oxygen saturation does not improve on 6 L/min via nasal cannula? The nurse should anticipate the need to escalate therapy. This would involve notifying the healthcare provider and preparing to switch to a higher-flow device, such as a simple face mask or a non-rebreather mask, to deliver a higher FiO₂.

How to Approach the Question

First, identify the core subject of the question, which is 'Oxygen administration through nasal cannula'.
This is a factual recall question that tests your knowledge of standard medical procedures.
Recall the different types of oxygen delivery systems and their corresponding flow rates.
A nasal cannula is a low-flow device. Eliminate the options with high flow rates (C and D).
Compare the remaining low-flow options (A and B). The range 1-6 L/min is the most comprehensive and standard accepted range for a nasal cannula.
Select the option that represents the complete standard range for the device mentioned.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 7-9

E6 Nursing Fundamentals Taylor p. 731-733

Practise the full IGIMS Staff Nurse - 2018

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