What do you think of this monitor?

JustBeachyNurse, LPN · Dec 31, 2015

I can see the reflection of the staff member taking the photo with a cell phone. Which greatly detracts from the values. The numbers aren't that bad though depending on patient condition. For one of my infant patients these numbers are very bad

LelahRN2be · Dec 31, 2015

Not me! This image was sent to me, pt has COPD, O2 levels are low, to me heart rhythm looks good

LelahRN2be · Dec 31, 2015

what about respirations?

JustBeachyNurse, LPN · Dec 31, 2015

Restorations of 25 are not that significant a little high but the patient presentation is more important. The O2 is perfectly normal. A COPD patient is usually 92-95% for baseline so a COPD with SpO2 of 94% is nothing to worry about. Don't treat the monitor, treat the patient. Increased work of breathing? Dyspnea on exertion? Wheezes? Rales? Edema? Cough? Productive? Rhonchi? Cap refill? Level of alertness/wakefulness? Color? Hydration status? Systolic BP is a little high but can be anxiety as diastolic is OK

KelRN215, BSN, RN · Dec 31, 2015

what about respirations?

How old is the patient? 25 is slightly tachypneic for an adult but not really anything I'd write home about. An O2 sat of 94% doesn't really excite me either. When I first took PALS, the Medic teaching the class showed us a video of a child with an O2 sat of 94% and to our lack of alarm said "I know what you're all thinking, you work at a children's hospital, you've seen worse." See cardiac kids with O2 sats in the 70s-80s all the time.

dah doh, BSN, RN · Dec 31, 2015

Why is the respiratory alarm off?

LelahRN2be · Dec 31, 2015

Patient stated that she has been diagnosed with CHF... to me her Rhythm and all looks great, She has dementia, could this be a false diagnosis?

kalycat, BSN, RN · Dec 31, 2015

Patient stated that she has been diagnosed with CHF... to me her Rhythm and all looks great, She has dementia, could this be a false diagnosis?

You can't dx CHF from a monitor alone. You have to look for the s/s of heart failure in the patient, which includes several of the things listed above. (Crackles, dyspnea, edema, etc just to name a few). I have heart failure patients with an EF of less than 20 who never leave sinus rhythm. EF is typically evaluated via echo, and as far as rhythms and conduction abnormalities go, 5 lead telemetry or a 12 lead ECG are going to give you much more meaningful data than simple 3 lead monitoring. You would also be looking at lab data for a true cardiac work up: enzymes, BNP, etc.

Not sure if this is homework or "for a friend" but just keep in mind that we are not allowed to give medical advice per the TOS for AN. Good luck.

RescueNinjaKy · Dec 31, 2015

I really don't know what's going on here. For my floor, cardiac step down, these numbers are nothing alarming to me. Sure the RR is elevated, but eh if they don't feel short of breath, and they look good im not too concerned. So my question to you op, what are you thinking is going on? What is your concern? What is it that you're looking for?

Karou · Dec 31, 2015

The picture is titled mawmaw, which is a odd to me. You said someone sent it to you, was this person a friend who wanted you to interpret the monitor for their grandmother (the patient)?

I also see you are a nursing student, and the person taking the photo can be seen in what looks like a lab coat with stethoscope. I hope it isn't you...

flyersfan88 · Dec 31, 2015

We have the same monitors on my floor and not once have the respirations been accurate. Treat your patient.