NCLEX-PN® ExaminationReduction of Risk PotentialMedium
A client is receiving oxygen therapy via nasal cannula at 4 L/min. The LPN notes the client's oxygen saturation is 90%, and the client reports increased shortness of breath. The LPN should first adjust the oxygen flow rate to:
- A6 L/min
- B10 L/min
- C8 L/min
- D2 L/min
Show answer & explanationAnswer & explanation
Correct answer: A. 6 L/min
The client's SpO2 is 90% (below the target of 92-96% for most clients) and they report increased shortness of breath. Increasing the oxygen flow rate to 6 L/min via nasal cannula is the immediate and appropriate action to improve oxygenation, as long as there is an order for titration or a standing order to maintain SpO2 above a certain level. 6 L/min is within the safe range for nasal cannula before considering a different delivery device.
Why the other options are wrong
- B. 10 L/min is too high for a nasal cannula and would require a different oxygen delivery device, such as a non-rebreather mask, for effective delivery.
- C. 8 L/min is typically too high for a nasal cannula, as it can cause drying of mucous membranes and may not be effectively delivered; a different device like a simple face mask might be considered.
- D. Decreasing the oxygen flow rate would worsen the client's hypoxemia and shortness of breath.
Nasal Cannula Oxygen Delivery
A low-flow oxygen delivery device that provides supplemental oxygen via two prongs inserted into the client's nostrils.
- Flow rate: 1-6 L/min
- FiO2 (fraction of inspired oxygen) varies with flow rate and client's breathing pattern
- Appropriate for clients requiring low-to-medium oxygen concentrations and stable breathing
Memory trick: Nasal Cannula: Not Too Low, Not Too High, Just Right for SpO2!