Skill 05[1]..pulse Oximetry
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20
SKILL 5
Pulse Oximetry
EQUIPMENT Pulse oximeter Appropriate sensor probe GENERAL GUIDELINES FOR VITAL SIGNS 1. Check record for baseline and factors (age, illness, medications, etc.) influencing vital signs. Provides parameters and helps in device and site selection. 2. Gather equipment, including paper and pen, for recording vital signs. Promotes organization and efficiency.
3. Cleanse site. Remove nail polish or artificial nails. Nail polish and artificial nails alter results. 4. Follow manufacturer’s instructions for setting up oximeter. Connect sensor to oximeter and set alarms as ordered. 5. Position sensor with light-emitting diode (LED) and photosensor aligned on opposite sides of the selected site. Prevents optical shunting and ensures accurate results. 6. Obtain reading.
3. Wash hands. Reduces transmission of microorganisms.
7. Watch pulse bar for pulse sensing.
4. Prepare child and family in a quiet and nonthreatening manner. Enhances cooperation and participation; reduces anxiety and fear, which can affect readings.
8. Obtain arterial blood gas (ABG) if ordered. Promotes confidence in oximetry readings. 9. Cover sensor. Ambient light can skew readings.
NOTE: Infants and young children may be quiet and more cooperative if vitals signs are obtained while child is sitting on caregiver’s lap. PREPROCEDURE 1. Determine if the child has undergone a test that used an intravenous dye. Intravenous dyes may interfere with pulse oximeter readings. 2. Evaluate client status. PROCEDURE 1. Follow steps 1–4 of General Guidelines. 2. Select sensor site that is free of moisture and drainage. Assess capillary refill and proximal pulse. Adequate perfusion necessary for accurate reading. a. Infant: Big toe or foot. (Figures 7 and 8) b. Toddler through adolescent: finger. NOTE: May also use earlobe.
FIGURE 7 Placement of pulse oximeter on toe.
FIGURE 8 Placement of pulse oximeter on foot.
Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.
continued
21
SKILL 5
Pulse Oximetry
continued
10. Assess probe/sensor site every 2–4 hours. Protects against skin breakdown; ensures correct placement. 11. Rotate probe/sensor site every 2 hours for a springloaded sensor and every 4 hours for an adhesive sensor. Maintains skin integrity. 12. Wash hands. Reduces transmission of microorganisms. DOCUMENTATION 1. Pulse oximetry readings at regular intervals per agency policy. 2. Site sensor applied, when changed. 4. Skin condition at sensor site. 3. Setting of alarm limits.
Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.
SKILL 5
Pulse Oximetry
EQUIPMENT Pulse oximeter Appropriate sensor probe GENERAL GUIDELINES FOR VITAL SIGNS 1. Check record for baseline and factors (age, illness, medications, etc.) influencing vital signs. Provides parameters and helps in device and site selection. 2. Gather equipment, including paper and pen, for recording vital signs. Promotes organization and efficiency.
3. Cleanse site. Remove nail polish or artificial nails. Nail polish and artificial nails alter results. 4. Follow manufacturer’s instructions for setting up oximeter. Connect sensor to oximeter and set alarms as ordered. 5. Position sensor with light-emitting diode (LED) and photosensor aligned on opposite sides of the selected site. Prevents optical shunting and ensures accurate results. 6. Obtain reading.
3. Wash hands. Reduces transmission of microorganisms.
7. Watch pulse bar for pulse sensing.
4. Prepare child and family in a quiet and nonthreatening manner. Enhances cooperation and participation; reduces anxiety and fear, which can affect readings.
8. Obtain arterial blood gas (ABG) if ordered. Promotes confidence in oximetry readings. 9. Cover sensor. Ambient light can skew readings.
NOTE: Infants and young children may be quiet and more cooperative if vitals signs are obtained while child is sitting on caregiver’s lap. PREPROCEDURE 1. Determine if the child has undergone a test that used an intravenous dye. Intravenous dyes may interfere with pulse oximeter readings. 2. Evaluate client status. PROCEDURE 1. Follow steps 1–4 of General Guidelines. 2. Select sensor site that is free of moisture and drainage. Assess capillary refill and proximal pulse. Adequate perfusion necessary for accurate reading. a. Infant: Big toe or foot. (Figures 7 and 8) b. Toddler through adolescent: finger. NOTE: May also use earlobe.
FIGURE 7 Placement of pulse oximeter on toe.
FIGURE 8 Placement of pulse oximeter on foot.
Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.
continued
21
SKILL 5
Pulse Oximetry
continued
10. Assess probe/sensor site every 2–4 hours. Protects against skin breakdown; ensures correct placement. 11. Rotate probe/sensor site every 2 hours for a springloaded sensor and every 4 hours for an adhesive sensor. Maintains skin integrity. 12. Wash hands. Reduces transmission of microorganisms. DOCUMENTATION 1. Pulse oximetry readings at regular intervals per agency policy. 2. Site sensor applied, when changed. 4. Skin condition at sensor site. 3. Setting of alarm limits.
Copyright © 2007 by Thomson Delmar Learning, a division of Thomson Learning, Inc. All rights reserved.
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