A 52-year-old man with a history of hypertension was diagnosed
with sleep apnea. Which oxygen therapy delivery method would
benefit this patient?
A. Nonrebreather mask
B. Incentive spirometry
C. Continuous positive airway pressure
D. Oxymizer Correct Answer C.
Continuous positive airway pressure (CPAP) keeps the terminal
airways (alveoli) partially inflated, reducing the risk for
atelectasis; if atelectasis has occurred, positive pressure assists
in reinflation. This is very beneficial in patients who retain
carbon dioxide, such as those with obstructive sleep apnea
(OSA) or acute exacerbations of COPD. CPAP keeps the airway
open and prevents upper airway collapse. As a result of CPAP
therapy, the patient breathes more normally, sleeps better, and
has markedly reduced snoring.
Acapella Device Correct Answer -designed to aid sputum
clearance
-handheld
-provides positive expiratory pressure and vibration
,-During exhalation pressure from the airways is transmitted to
the Acapella device, which helps mucus dislodge from the
airway walls and as a result prevents airway collapse,
accelerates expiratory flow, and moves mucus toward the
trachea.
-Some patients with cystic fibrosis may have greater benefit
from this device versus standard chest physiotherapy.
-two types
Administering O2 therapy to a patient with an artificial airway
Correct Answer -humidification is required
parts include:
-T tube: The T tube, also called a Briggs adaptor, is a T-shaped
device with a 15-mm connection that connects an oxygen source
to an artificial airway such as an endotracheal (ET) tube or
tracheostomy
-Trach collar: a curved device with an adjustable strap that fits
around a patient's neck. collects sputum. Always document with
O2 %
Artificial airway suctioning Correct Answer -Endotracheal
(ET) tubes and tracheostomy tubes (TTs) are artificial airways
inserted to relieve airway obstruction, provide a route for
mechanical ventilation, permit easy access for secretion
removal, and protect the airway from gross aspiration in patients
with impaired cough or gag reflexes.
,Blue device (Acapella) Correct Answer is for patients who
cannot maintain their expiratory flow above 15 L/min for greater
than 3 seconds
Can feeding tube insertion be delegated to a NAP? Correct
Answer No; however, they can help with patient positioning
and comfort measures during insertion
Can removing an impaction be delegated to a NAP? Correct
Answer No
Can the assessment of a patient's risk to aspirate be delegated to
a NAP? Correct Answer No; However, NAP may feed
patients after receiving instruction on aspiration precautions.
Can the initial assessment of a pt's condition be delegated?
Correct Answer No; however, the skill of follow-up PERF
measurements can be
Can the skill of inserting and maintaining an NG tube be
delegated to a NAP? Correct Answer No
Can the task of administering oxygen therapy to a patient with
an artificial airway be delegated to NAP? Correct Answer No
Can the task of airway suction with a closed (in-line) suction
catheter be delegated to NAP, except in special situations?
Correct Answer No
Can the task of applying a nasal cannula or oxygen mask be
delegated to nursing assistive personnel? Correct Answer Yes
, Can the task of assisting a patient to use incentive spirometry
(IS) be delegated to NAP? Correct Answer Yes
Can the task of caring for a patient receiving noninvasive
ventilation be delegated to NAP? Correct Answer No
Can the task of performing oropharyngeal (Yankauer)
suctioning be delegated to nursing assistive personnel (NAP)?
Correct Answer Yes
Can the task of performing percussion and vibration be
delegated to NAP? Correct Answer Yes
Can the task of postural drainage be delegated to nursing
assistive personnel (NAP)? Correct Answer Yes
Can the task of using an acapella device be delegated? Correct
Answer Yes
Can the tasks of nasotracheal and new artificial airway
suctioning be delegated to NAP? Correct Answer No
Chest Physiotherapy Correct Answer -Used to mobilize
pulmonary secretions
-Includes physical chest wall maneuvers
> Percussion
>Vibration
>Shaking
>Postural drainage