Question

Pulse Oximetry on the Your physician asks you to measure the oxygen saturation level of the patients listed. For each situation, answer the following questions: a. What would you do in each situation to prevent an inaccurate pulse oximetry reading? b. What occurs with each of these situations and how does it affect the Spo, reading! 1. Kelly Collins, a patient with chronic bronchitis, is wearing navy blue nail polish.. 2. Melvin Hosey has Parkinson's disease and is having difficulty controlling tremors in his hands. 3. Scott Kimes, a patient with emphysema, frequently experiences periods of prolonged coughing. 4. Nicole Lowe has returned to the office for a recheck of her viral pneumonia. You are getting ready to measure her oxygen saturation and notice that bright sunlight is coming through the window where she is seated and shining on her hand. 5. Rebecca Bensie, a patient on oxygen therapy, is morbidly obese, and you are having trouble properly aligning the oximeter probe on her finger. brodogra darstels Blood Pressure Measurement Using the principles outlined in your textbook, explain what happens under the following circumstances: 1. The blood pressure is taken on a patient who has just undergone vigorous physical exercise. 2. The blood pressure is taken on a patient with tight sleeves. 3. The blood pressure is taken on an apprehensive patient. olloqa 4. An adult cuff is used to measure blood pressure on a young child. Improper cuff size common cause of an inacurat c blood presure measurement 5. The blood pressure is taken over clothing. Clothing interferes with the abil Korotkoff sounds Proper Blood Pressure Cuff Selection Measurements of the arm circumference in centimeters) are given for various patients. Using Table 19-9 in your textbook, indicate what size of blood pressure cuff (child, small adult, adult, large adult, or adult thigh) should be used with each of these patients. bl o od 147m.Adult thigh ? 20cm: Child arm

Answer 1

PULSE OXIMETRY

Oxygen saturation level refers to percentage of hemoglobin which is occupied by oxygen. A specific balance of oxygen is required for human beings for leading a healthy life and normal arterial blood oxygen saturation level is 95 to 100 percent.

1. Kelly Collins, a patient with chronic bronchitis, is wearing navy blue nail polish.

a. Nail polish of the patient must be removed using acetone or nail polish remover as it can lead to false low pulse oximeter readings.

b. Blue nail polish can significantly lower the oxidation saturation level (SPO2) reading. This is because blue nail polishes interferes with light transmission through the finger and absorbs light at wavelengths used by pulse oximeter (660 nm and 940 nm), leading to inaccurate readings.

2. Melvin Hosey has Parkinson’s disease and is having difficulty controlling tremors in his hands.

a. In this case, oxygen saturation level must be monitored by a sensor attached to toe or earlobe.

b. Motion can affect pulse oximeter readings. During motion, it can show false non-existent hypoxemia or low reading. This is due to the fact that motion can significantly interfere with the path of light travelling from LED to photodetector of pulse oximeter. This in turn can cause the instrument to pick up the wrong pulse signal or even prevent in having any readings at all.

3. Scott Kimes, a patient with emphysema, frequently experiences periods of prolonged coughing.

a. In this case, oxygen saturation level must be monitored at a time when the patient is not coughing. If this is not possible, monitoring must be done at a site which is less affected by motion. This includes regions of toes or earlobes.

b. Coughing can lead to vigorous motion and motion can affect pulse oximeter readings and significantly interfere with the path of light travelling from LED to photodetector of pulse oximeter leading to inability to pick up the right pulse signal.

4. Nicole Lowe has returned to the office for a recheck of her pneumonia condition. You are getting ready to measure her oxygen saturation and notice that bright sunlight is coming through the window where she is seated and is shining on her hand.

a. The window must be covered using blinds or curtains or the patient should be asked to move her hand away from sunlight while taking the reading.

b. Light can result in inaccurate readings. This occurs when ambient light gets picked up by the photodetector and cause false reading.

5. Rebecca Bensie, a patient on oxygen therapy, is morbidly obese, and you are having trouble properly aligning the oximeter probe on her finger.

a. If it is difficult to align the oximeter probe on the patient’s finger, use another site like ear lobe to monitor the reading.

b. The oximeter probe is made up of two parts the LED and the photodetector. Light gets transmitted from the LED to the photodetector through tissues. Right transmission occurs only when the two parts are aligned directly opposite to each other. In this case, due to obesity, the patient has very large fingers and as a result proper alignment is not acquired resulting in inaccurate reading.