A patient's pulse oximeter alarm goes off. The monitor reads 82%. What is the first action the nurse should perform?
a. Prepare to intubate.
b. Assess the patient's condition.
c. Turn off the alarm and reapply the oximeter sensor.
d. Increase O2 level to 4L/NC.
B
The first nursing action would be to assess the patient to see if there is a change in his or her condition. If the patient is stable, then the nurse would turn off the alarm and reapply the oximeter sensor. The pulse oximeter cannot differentiate between normal and abnormal hemoglobin. Elevated levels of abnormal hemoglobin falsely elevate the Spo2 . The ability of a pulse oximeter to detect hypoventilation is accurate only when the patient is breathing room air. Because most critically ill patients require some form of oxygen therapy, pulse oximetry is not a reliable method of detecting hypercapnia and should not be used for this purpose.
You might also like to view...
Which respiratory condition reported by a patient when you obtain the family health history is not considered to be a familial disease?
a. lung cancer c. pneumonia b. tuberculosis d. alpha1-antitrypsin deficiency
A 14-year-old girl has a sunburn to her shoulders, which are red and blanch with pressure. This is classified as which of the following?
A) Superficial partial-thickness B) Deep partial-thickness C) Full-thickness D) Scald
Which statement best describes the role of the nurse in the therapeutic milieu of a psychiatric unit?
A) The treatment team member who is responsible for management of the therapeutic milieu B) The treatment team member who develops the medical diagnosis for all clients in the unit C) The treatment team member who provides for the spiritual and comfort needs of the client and his or her family D) The treatment team member who conducts individual, group, and family therapy after an in-depth psychosocial history
The professional in the allied health team whose job it is to assist the individual in the formulation of speech and the ability to articulate words and to understand and initiate speech is the:
a. occupational therapist. b. speech therapist. c. physiotherapist. d. nurse.