Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Medical & Surgical Nursing
Easy
Which of the following method is used for high flow oxygen administration:
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- High-Flow Nasal Cannula (HFNC) is a specialized oxygen delivery system designed to provide heated, humidified oxygen at very high flow rates, often up to 60 liters per minute.
- The primary characteristic of a high-flow system is that the flow rate from the device meets or exceeds the patient's peak inspiratory flow demand.
- This ensures a more stable and precise fraction of inspired oxygen (FiO₂) is delivered to the patient, making it ideal for treating moderate to severe hypoxemia and respiratory distress.
- The heating and humidification of the gas improves patient comfort and tolerance, and helps maintain normal mucociliary function.
Why Other Options Were Wrong
- Option B: A non-rebreather mask is a low-flow device. While it delivers a high concentration of oxygen (FiO₂), its flow rate (10-15 L/min) does not meet the patient's total inspiratory demand, leading to entrainment of room air.
- Option C: A simple face mask is a low-flow device that delivers a moderate and variable FiO₂ (35-50%) at flow rates of 6-12 L/min. It is not capable of providing high-flow therapy.
- Option D: Nasal prongs (standard nasal cannula) are a low-flow device used for delivering low concentrations of oxygen (24-44%) at flow rates of 1-6 L/min.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Oxygen Delivery Systems: High-Flow vs. Low-Flow as background academic context rather than a clinical decision trigger.
- Nurses must be able to differentiate between high-flow and low-flow oxygen systems to select the appropriate device based on the patient's clinical condition, oxygen requirements, and the provider's orders.
- When caring for a patient on HFNC, key nursing responsibilities include monitoring respiratory status, ensuring proper fit of the cannula, checking that the temperature and humidity settings are appropriate to prevent mucosal drying, and titrating flow and FiO₂ as ordered.
- Patient safety: Incorrectly classifying a device can lead to under-oxygenation. For example, using a simple mask on a patient who requires high-flow support will not meet their respiratory demand and can worsen their condition.
How to Approach the Question
- First, identify the key phrase in the question: "high flow oxygen administration". This is the central concept being tested.
- Differentiate between the concepts of "high flow" (the total volume of gas delivered per minute) and "high concentration" (the percentage of oxygen in the gas, or FiO₂). The question specifically asks for high flow.
- Review the capabilities of each option. Recall the typical flow rates for each device.
- Compare the flow rates: Nasal prongs (1-6 L/min), Simple mask (6-12 L/min), and Non-rebreather mask (10-15 L/min) are all significantly lower than HFNC.
- Recognize that only the High-Flow Nasal Cannula (HFNC) is designed to deliver flow rates (up to 60 L/min) that can meet or exceed a patient's total inspiratory demand.
- Conclude that HFNC is the only true high-flow system among the choices provided.
Concept Tested & Keywords
- Concept Tested: Oxygen Delivery Systems: High-Flow vs. Low-Flow
- Stem keywords: high flow, oxygen administration
- Lead-in keywords: Which
- Negative lead-in flag: false
Question ID
QAuFt8EkNlKk-5wfFGn2WG
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 7-9
E6 Nursing Fundamentals Taylor p. 731-733
Practise the full Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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