AIIMS Jodhpur SNO-2023
Medical & Surgical Nursing
Easy
A patient with COAD has to be put on oxygen using a face mask. Identify the type of mask shown in the picture above.
Appeared in: AIIMS Jodhpur SNO-2023
Explanation
- The device shown in the image is a Venturi mask, which is uniquely identified by the color-coded air-entrainment adapter (orange in this case) at its base.
- Venturi masks operate on the Venturi principle, mixing a precise volume of room air with a fixed flow of oxygen to deliver a specific and reliable fraction of inspired oxygen (FiO₂).
- This precision is critical for patients with COAD (COPD), as they often rely on a hypoxic drive to breathe. Uncontrolled high-concentration oxygen can suppress this drive, leading to hypercapnia and respiratory failure.
- Each color-coded adapter corresponds to a specific FiO₂ and required oxygen flow rate, making the Venturi mask the safest choice for this patient population.
Why Other Options Were Wrong
- Option A: A CPAP (Continuous Positive Airway Pressure) mask is used to provide positive pressure to keep airways open, not primarily for oxygen concentration delivery. It has a different structure and is used for conditions like sleep apnea or acute respiratory failure.
- Option B: A simple face mask delivers a variable and imprecise FiO₂ that depends heavily on the patient's breathing pattern. It is also contraindicated for patients who retain CO₂, a common characteristic of COAD, as low flow rates can lead to rebreathing of exhaled carbon dioxide.
- Option C: A face mask with a reservoir bag (a partial rebreather or non-rebreather mask) is designed to deliver a high concentration of oxygen (60-90%). This high FiO₂ is generally contraindicated for COAD patients as it can eliminate their hypoxic drive to breathe.
Related Visual
- Visual 1: Infographic: A chart displaying the different color-coded Venturi mask adapters (e.g., blue, white, yellow, red, orange, green) with their corresponding FiO₂ percentages and required oxygen flow rates.
- Visual 2: Diagram: Side-by-side comparison of a Simple Face Mask, Venturi Mask, and Non-Rebreather Mask, highlighting their key structural differences (vents, entrainment adapter, reservoir bag).
Clinical Relevance
- Nursing practice connection: Use the key finding related to Identification and application of oxygen delivery devices for patients with COAD/COPD to guide bedside assessment, documentation, and the next nursing action.
- Choosing the correct oxygen delivery device is a critical nursing responsibility to ensure patient safety, especially in patients with chronic respiratory conditions like COPD.
- Administering too high a concentration of oxygen to a COPD patient can lead to carbon dioxide retention, respiratory acidosis, and eventual respiratory arrest. Always start with a low, controlled concentration.
- Nurses must ensure the air-entrainment ports on a Venturi mask are open and not blocked by bed linens or clothing, as this would alter the FiO₂ delivered and could be dangerous.
How to Approach the Question
- First, analyze the image to identify the key distinguishing feature of the equipment. In this case, it's the orange-colored adapter at the base of the mask.
- Second, recall the different types of oxygen masks and their unique features. The colored adapter is the hallmark of a Venturi mask.
- Third, consider the clinical context provided in the question: 'a patient with COAD'. This is a major clue that points towards a specific clinical need.
- Finally, connect the identified device with the patient's condition. Ask yourself: 'Why is this specific mask the best choice for a COAD patient?' This leads to considering the need for precise FiO₂ delivery to avoid suppressing the hypoxic drive.
Concept Tested & Keywords
- Concept Tested: Identification and application of oxygen delivery devices for patients with COAD/COPD.
- Stem keywords: COAD, oxygen, face mask, identify
- Lead-in keywords: Identify
- Clinical cues: The patient's diagnosis of COAD is the critical piece of information that guides the selection of the appropriate oxygen delivery device.
- Negative lead-in flag: false
Question ID
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Attempt every question from this paper in a timed mock, then review the full solution for each one.
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