An 86-year-old female with a history of tuberculosis has rhonchi in the left lower lung. After donning an N-95 respirator, which oxygen delivery method is appropriate?

• A. simple face mask and don protective coveralls and booties.
• B. venturi mask and place her in the recovery position.
• C. nasal cannula and place a surgical mask over her nose and mouth.
• D. non-rebreather mask and place her in the semi-Fowler's position.

Answer: (C)

Infections spread through the air require protecting the caregiver while still delivering oxygen in a way that minimizes aerosol dispersal. After the staff puts on an N-95, using a nasal cannula to deliver low-flow oxygen provides comfortable, adequate oxygenation for an elderly patient with respiratory symptoms. Placing a surgical mask over the nose and mouth while the cannula is in place helps trap exhaled air and droplets, reducing the amount of potentially infectious material that escapes into the room without significantly hindering oxygen delivery.

Other mask options can leak more around the edges and may generate more dispersion of aerosols, and high-flow or tight-fitting masks aren’t necessary when a nasal cannula with a containment layer offers a safe, effective balance given the need for infection control and patient tolerance. The position choice is less critical here than ensuring safe oxygen delivery with containment of exhaled air.