Low O2 sat - page 2

what does it mean when theres a low o2 sat? what causes it? whats happening when there is a low o2 sat?... Read More

  1. by   Tweety
    Quote from TexasAngel
    Ok, can you tell me what atelectasis is? That is the only one I am not familiar with. Thanks.
    As said above, it's a partial or complete collaspsing of the lung. It most commonly occurs in the bases at the alveolar level (sp?). It's the complication we try to prevent post operatively when we ask our patients to turn, cough, deep breath, and ambulate.

    Again, off the top of my head.
  2. by   Tweety
    I wouldn't necessary focus on the 02 sat with the self-care deficit (which is a good one by the way). The 02 sat would more readily go with activity inolterance, ineffective breathing pattern type of ND's. (Where's Daytonite when I need her, becuase I'm not the expert on these kinds of things).

    Good luck!
  3. by   KyPinkRN
    Quote from Liz21
    ok..well im working with a patient who is very lethargic, weak, and fatigue. his respirations are within normal range (18breaths/min), however the patient's O2 sat is 92%..

    what im trying to figure out is a nursing dx for this patient, which i came up with "Self-care deficit r/t limited physical mobility as evidenced by lethargic, weaness, fatigue, low o2 sat, and altered mental status" does this sound ok? im trying to figure a nursing dx that relates with his low o2 sat as well as limited mobility. this is a patient who cant do much because of neurological conditions.

    should i just do a nursing dx "Failure to thrive" or stick to the one that i have which is the one about self-care deficit?

    I would write something like this... impaired gas exchange r/t fatigue... m/b low o2 sat etc...(other assessment data).
  4. by   lisabeth
    Thanks for the answer guys. I know I will learn all of that, but I just cant read something and not know what it is.
  5. by   lisabeth
    I feel like your avatar is staring at me like I asked a stupid question.

    Quote from Don3218
    Atelectasis is a partial or incomplete expansion of the lung or a collapse of the lung.
  6. by   Daytonite
    Low oxygen saturation is also called hypoxemia, reduced oxygenation of the arterial blood.

    The causes of low blood oxygen saturation
    • inspired air does not contain enough oxygen (high altitudes, inhaling poorly oxygenated gases, breathing in an enclosed space)
    • the patient hypoventilates (the respiratory center is inappropriately stimulated by an overdosage or neurological damage as in increased intracranial pressure, diabetic ketoacidosis, end-stage respiratory failure of chronic obstructive pulmonary disease)
    • there is insufficient blood volume to carry hemoglobin oxygen (massive hemorrhage)
    • blood, for some reason, is able to bypass the lungs (arteriovenous shunt)
    • the surface area of the lung tissue has been damaged so gas exchange is impaired (alveolar capillary diffusion abnormality of emphysema, fibrosis or pulmonary edema; ventilation-perfusion mismatch as in asthma, chronic bronchitis or pneumonia).
    Low oxygen concentration, in and of itself, merely means that the amount of oxygen being carried in the blood by the red blood cells is low. However, if it continues for any length of time it proceeds to another much more serious condition called hypoxia which is reduced oxygen available to the cells and tissues of the body. Hypoxia is a lack of oxygen from any cause and results in an increased respiratory rate, restlessness, impaired judgment, tachycardia, dyspnea and cyanosis. Cells and tissues cannot thrive for very long without any oxygen at all.

    Lethargy is a symptom related to the patient's level of consciousness. Weakness is a symptom that involves the muscles and is a lack of strength seen in anemias. Fatigue is a symptom that is seen in anemia, COPD, carbon monoxide poisoning and as a side effect of some drugs.

    http://www.fpnotebook.com/REN56.htm - PaO2
  7. by   donsterRN
    Quote from TexasAngel
    I feel like your avatar is staring at me like I asked a stupid question.
    I had to scroll back to see which avatar I was using!

    You know that's Mike Wizowski's normal look and that you shouldn't take it personally...!!! It was an excellent question; we just covered respiratory in A&P, so the material was still somewhat fresh. Ask me again n a couple of weeks, and I'll undoubtedly have to look it up!
  8. by   lisabeth
    Honestly, I was joking. It is a cute avatar. I did not take it personally. I just thought it was funny the way it is just staring out at me.

    Quote from Don3218
    I had to scroll back to see which avatar I was using!

    You know that's Mike Wizowski's normal look and that you shouldn't take it personally...!!! It was an excellent question; we just covered respiratory in A&P, so the material was still somewhat fresh. Ask me again n a couple of weeks, and I'll undoubtedly have to look it up!
  9. by   Daytonite
    Quote from liz21
    ok..well im working with a patient who is very lethargic, weak, and fatigue. his respirations are within normal range (18breaths/min), however the patient's o2 sat is 92%..

    what im trying to figure out is a nursing dx for this patient, which i came up with "self-care deficit r/t limited physical mobility as evidenced by lethargic, weaness, fatigue, low o2 sat, and altered mental status" does this sound ok? im trying to figure a nursing dx that relates with his low o2 sat as well as limited mobility. this is a patient who cant do much because of neurological conditions.

    should i just do a nursing dx "failure to thrive" or stick to the one that i have which is the one about self-care deficit?
    you really haven't supplied enough of your assessment data. there are several self-care deficit diagnoses. what specifically isn't the patient able to do with regard to his self-care and exactly what can he and can't he accomplish? these are things that should have been determined in your assessment. for example, you should have information such as "only able to wash body with one arm", or "became tired after 10 steps and had to sit down". this kind of assessment information is more descriptive than the terms "weakness" or "fatigue". also, if you refer to a care plan or nursing diagnosis book for the nursing diagnosis of any of the self-care deficits they should list for you the related factors (cognitive impairment, decreased motivation, environmental barriers, inability to perceive body part, inability to perceive spatial relationship, musculoskeletal impairment). fatigue, pain, severe anxiety and weakness are additional related factors for dressing/grooming, feeding and toileting self-care deficits. the "as evidence by" items of your diagnostic statements need to consist of the actual assessment data you obtained that fits with this diagnosis. that would be things like "became tired after 10 steps and had to sit down" which would further clarify the fatigue.

    so, you need to further clarify which self-care deficits you are going to address. there are four of them: (1) bathing/hygiene, (2) dressing/grooming, (3) feeding, and (4) toileting. these are all adls. your nursing diagnostic statement would then be written as: (bathing/hygiene, dressing/grooming, feeding, toileting) self-care deficit r/t neurological impairment, lethargy, weakness and fatigue aeb [specific assessment data].

    as for this 92% oxygen saturation. . .is this considered an abnormal value? when you are determining nursing diagnoses you taking into consideration the abnormal assessment data. normal assessment data is not posing a problem for the patient, so is not necessary to care plan. 92% is still considered within normal limits for an o2 saturation.

    the nursing diagnosis of adult failure to thrive has the following definition: "progressive functional deterioration of a physical and cognitive nature. the individual's ability to live with multisystem disease, cope with ensuing problems, and manage his/her care are remarkably diminished". the related factor for this diagnosis is depression. the defining characteristics (symptoms) are: altered mood state, anorexia, apathy, problems with responding to environmental stimuli, demonstrated difficulty in concentration, demonstrated difficulty in decision making, demonstrated difficulty in judgment, demonstrated difficulty in memory, demonstrated difficulty in reasoning, decreased perception, consumption of minimal to no food at most meals, decreased participation in adls, decreased social skills, expresses loss of interest in pleasurable outlets, frequent exacerbations of chronic health problems, inadequate nutritional intake, neglect of home environment, neglect of financial responsibilities, physical decline, self-care deficit, social withdrawal, unintentional weight loss, verbalizes desire for death (nanda-i nursing diagnoses: definitions & classification 2007-2008 published by nanda international, page 78). you haven't included enough assessment information about this patient to indicate that failure to thrive is a problem here.

    for information on writing care plans please refer to these two threads:

    Last edit by Daytonite on Apr 4, '07
  10. by   cherokeesummer
    Woohoo, Daytonite ROCKS! :bowingpur

    I really appreciate the detailed answers!
  11. by   hossdog
    Well, how about poor tissue perfusion, decreased cardiac output and activity intolerance as issues that relate to decreased o2 sat?...
  12. by   mkblakley07
    Aren't normals for O2 sat 95%-100%? That's what it says in my fundamentals textbook... It's the previous edition, but that's what it says. But my Health Assessment textbook says that anything under 90% is considered abnormal...hmmm

    how are your patients lung sounds? when he/she coughs, can she get rid of the sputum? If not, maybe the low 02 levels are related to ineffective airway clearance.

    just my
  13. by   GeneralJinjur
    Aren't normals for O2 sat 95%-100%? That's what it says in my fundamentals textbook... It's the previous edition, but that's what it says. But my Health Assessment textbook says that anything under 90% is considered abnormal...hmmm
    This depends on the patient and your altitude. In Colorado, we're happy with a 93. OTOH, if it's a patient with emphysema, you don't want them saturated at 100%. That may be what your Assessment text is referencing.

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