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July 18 -NCLEX Daily Practice Questions
Thursday
The nurse teaches safety precautions of home oxygen use to a client with emphysema being discharged with a nasal cannula and portable oxygen tank. Which client statement indicates the need for further teaching? Select all that apply.
1. “I can apply Vaseline to my nose when my nostrils feel dry from the oxygen.”
2. “I can cook on my gas stove as long as I have a fire extinguisher in the kitchen.”
3. “I can increase the liter flow from 2 to 6 liters a minute whenever I feel short of breath.”
4. “I should not polish my nails when using my oxygen.”
5. “I should not use a wool blanket on my bed.”
Oxygen is a colorless, odorless gas that supports combustion and makes up about 21% of the atmosphere. Oxygen is not combustible itself, but it can feed a fire if one occurs. When using home oxygen, safety precautions are imperative. 1. Vaseline is an oil-based, flammable product and should be avoided. A water-soluble lubricant may be used instead. 2. Oxygen canisters should be kept at least 5-10 feet away from gas stoves, lighted fireplaces, wood stoves, candles, or other sources of open flames. Clients should use precautions as cooking oils and grease are highly flammable. 3. The prescribed concentration of oxygen, usually 24%-28% for clients with COPD, should be maintained. Oxygen is prescribed to raise the PaO2 to 60-70 mm Hg and the saturations from 90%-93%. A flow rate of 2 L/min provides approximately 28% oxygen concentration, and 6 L/min provides approximately 44%. Higher rates usually do not help and can even be dangerous in clients with COPD as they can decrease the drive to breathe. The client should notify the care provider about excessive shortness of breath as additional treatment may be indicated. (Option 4) The client understands that nail polish remover and nail polish contain acetone, which is highly combustible. (Option 5) Clients should avoid synthetic and wool fabrics because they can cause static electricity, which may ignite a fire in the presence of oxygen. Clients should use cotton blankets and wear cotton fabrics. Educational objective: Safety precautions for home oxygen use include the following: no smoking; electrical devices in good condition and plugs grounded; avoiding volatile, flammable products and materials that generate static electricity; staying at least 5-10 feet away from open sources of flame; keeping fire extinguishers readily available; and regularly testing smoke detectors.
