A 40-year-old client has just had extensive surgery involving both his lower limbs. Which nursing consideration is most important for the nurse to keep in mind when using a pulse oximeter for recording oxygen saturation?
A) Avoid using alcohol to clean the site where the sensor is applied.
B) Ensure that the sensor is placed over the client's thumb or toe.
C) Ensure that the alarm is set when performing continuous analysis.
D) Avoid moving or changing the position of the sensor.
C
Feedback:
If continuous monitoring is ordered, the nurse ensures that the alarms are on before leaving the client. This ensures the nurse is notified if the values are out of the desired range (indicating a possible problem that requires intervention). Alcohol is very effective in cleaning the site where the sensor is applied. The area swabbed with alcohol is dried adequately before fixing the sensor over it. The sensor is ideally placed on the client's index, middle, or ring finger and not over the client's thumb or toe. Moreover, the client may have decreased or altered circulation in the lower extremities following the surgery, thus altering the results of the procedure. The sensors may have to be moved frequently to observe for tissue breakdown or irritation from adhesives or clips.
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