Question

Critical Thinking Questions Scenario: Mrs. Maskowitz is a lance wearing a nonrebreathing was. Maskowitz is a 60-year-old woman with COPD who is admitted to the emergency department (ED) via ambu- ning a nonrebreathing mack at 10 Lm Mr Plaskowitz, who was a wake and alert when the ambulance arrived at ne, is now extremely lethargic and somnolent. The ED physician orders you to change the oxygen delivery device to a nasal cannula 1. Briefly explain the cause of the patient's lethargy. Ofhent feels lethargic because COPD reduces au flow in to the ling which make it diseault to breat. Also reduces the subtly the whole body receitas, the body will feel tired and exhausted Willout enough Oxueen. 2. If the patient were to remain on the nonrebreathing mask for at least 24 hours, what complications or hazards could result from (a) the delivery method, and (b) the resulting oxygen concentration? 3. What liter flow would you recommend to the physician for the nasal cannula? 4. The pulmonary physician, who has been called in on this case, requests that you change the delivery device to a Venturi mask at a comparable Frog A. What Fro, should be used? B. The patient is noted to have a minute ventilation of 15 Lpm. What is the minimum liter flow, at this Fio required to meet the patient's inspiratory flow demand? Show your work. 5. Why is a minimum flow rate of 5 Lpm recommended for oxygen delivery by mask? 6. Why will an air entrainment mask never deliver 100% oxygen?

Answer 1

Answer to question number 2:

a)Nonrebreathing mask should be used only for short period,prolonged use causes high oxygen concentrations which is contraindicated in this patient (For COPD patients O2 saturation should be maintained at 90-92%. ).

b)Excess oxygen administration or high oxygen concentration  leads to pulmonary and ocular toxicity can also cause hypercarbia (excess co2) which further leads to alterations in mental state.