Question about Pulse Oximetry

  1. 0 I have been taking pulse oximetries for the past 2 years now. I have taken O2 sats on patients that are 80 years old in the 95-99 range. For the last two years I have been taking mine, and it has been in the 94-96 range. I don't smoke. I'm overweight (as you know nursing school does this :chuckle ) but can that play a major role in my sats being low? I'm 6'1'' 260lbs. A lot of that weight is still muscle from where I worked out before school started. I've been broke eversince Anyways, I just wanted to know if there are any substantial reasons for my sats constantly remaining in the 94-96 range. It gets me upset to see these 90yo pt's with sats in the 95-99 range and me below that. Oh, I'm also 24yo if that helps.
  2. Visit  DustinRN profile page

    About DustinRN

    Joined Aug '03; Posts: 126; Likes: 1.

    12 Comments so far...

  3. Visit  Tenesma profile page
    0
    1) atelectasis
    2) possible right to left shunt due to PFO in the setting of pulmonary hypertension due to chronic obstructive sleep apnea due to your weight

    just a few thoughts...
  4. Visit  duckboy20 profile page
    0
    Is a lot of your weight in your belly are is it spread out proportioned? If you have a lot of stomach weight then that will make you breath shallower than a person without the weight. This could cause atelectasis as Tenesma said. Sit in a chair and hook up the pulse ox and breath very deep breaths for about a minute at about your normal rate. See if you see a change in the readings
  5. Visit  DustinRN profile page
    0
    Okay, now I'm freaked out. I never thought I could have atelectasis or chronic obstructive sleep apnea. I wake up like 5 times a night!!! What should I do? Will incentive spirometry help me out any if I have atelectasis. I'm really scared now about this atelectasis thing because whenever I participate in sports I do a lot of pursed lip breathing after a short amount of time. I constantly wake up in the middle of the night so that makes me wonder about chronic obstructive sleep apnea :uhoh21: And yes, I have gained a good amount of weight in my abd area. Good lord, I need a benzo :imbar
  6. Visit  DustinRN profile page
    0
    Just ignore this message.
  7. Visit  Tenesma profile page
    0
    dustin... everybody is atelectatic to one degree or another, in fact it is very rare to see a sat greater than 97-98 on room air... the more overweight or the more restricted your chest is, the worse it is...

    and yes you could have sleep apnea... with your weight i would bet money on it, but the only true treatment is nocturnal CPAP... speak with your PCP and have them refer you for a sleep study... almost all patients who tolerate CPAP actually report back to me that their life is completely changed for the better, because they now can sleep during the night and be fully energized during the day (compared to before when they would doze off when reading or watching TV or sitting on the couch)...

    incentive spirometry is not going to make a difference for you... unless you do it right before you check your pulse ox....

    and yes you are right, pursed-lip breathing pattern is a sign of chronic obstructive disease - your body is creating an environment where you can have a longer E to I ratio, to assist with blowing off CO2
  8. Visit  DustinRN profile page
    0
    Quote from Tenesma
    dustin... everybody is atelectatic to one degree or another, in fact it is very rare to see a sat greater than 97-98 on room air... the more overweight or the more restricted your chest is, the worse it is...

    and yes you could have sleep apnea... with your weight i would bet money on it, but the only true treatment is nocturnal CPAP... speak with your PCP and have them refer you for a sleep study... almost all patients who tolerate CPAP actually report back to me that their life is completely changed for the better, because they now can sleep during the night and be fully energized during the day (compared to before when they would doze off when reading or watching TV or sitting on the couch)...

    incentive spirometry is not going to make a difference for you... unless you do it right before you check your pulse ox....

    and yes you are right, pursed-lip breathing pattern is a sign of chronic obstructive disease - your body is creating an environment where you can have a longer E to I ratio, to assist with blowing off CO2

    Oh my god, you hit me right on the nail when you talked about dozing off when reading, watching TV, or sitting on the couch. That is so me! If I lie down with my med-surg book to read my book and I are taking a nap:chuckle I don't know if I've had this feeling of being energized in quite some time. I really appreciate the advice. I think I will make that appointment to see my PCP. Thanks again Tenesma.

    Also, will my PCP be able to tell if I have atelectasis from a chest x-ray?

    Thanks
  9. Visit  Tweety profile page
    0
    I guess it goes without saying that you should.....um lose the weight.

    Most of us don't use our lungs to their fullest capacity. I've always used deep breating exercises as a form of relaxation.

    Good luck in getting any answers.


    (I've always gotten very sleepy whenever I read med-surg books, or currently the critical care nursing book. Seems to be a natural reaction to me. )
    Last edit by 3rdShiftGuy on Mar 10, '04 : Reason: typos of course :)
  10. Visit  duckboy20 profile page
    0
    Probably the best thing you can do for yourself is to get yourself in shape. I know you are in school and how hectic things are but you have to take care of yourself too. I really do not think you have anything lung related with you being so young. My bet is that your body has gotten used to breathing shallower than normal due to the weight and that is causing a decrease in oxygen levels which would cause you to be really tired. Try putting a pillow or two under your back and sleeping with your head elevated a little, if it is comfortable, and let gravity help while you sleep. I would ask your pcp about CPAP but I doubt he would want to start you on that being so young unless it is a real problem which he should order a sleep study on you first. Don't sweat or fret, doubtful anything at all to be overly concerned about.
  11. Visit  gwenith profile page
    0
    I would go to your PCP and get your heart and lungs checked esp if you are pursed lip breathing post excercise. There are lots and lots of reasons for a low SaO2 and some are simple i.e. are you wearing black nail polish - ooops - I see you are a guy

    The only person who can really give you answers is your family doctor - good luck!!! And think of it this way - if we can treat your underlying problem then maybe you will be able to get fitter and lose weight. Many sleep apnoea patients have the problem of being tired all the time which predisposes them not to exercise which causes weight gain and which increases apnoea - it can be a vicious cycle.

    Oh! and if you are smoking - definitely give that up.
  12. Visit  nialloh profile page
    0
    Dustin, you were given very good advice here. I am in your boat. I was aways tired, even after getting 10-11 hours of sleep. I am about your weight, but not as tall. So one day on my unit, I mentioned it to one of the resp Dr.s . He set me up with a sleep study, with the end result being I use CPAP at night. I am now well rested after only 7 hours of sleep. The Dr also said I could also probably get rid of the CPAP if I lost 30-40 lbs.
    So give it a try, even if only for piece of mind.
  13. Visit  DustinRN profile page
    0
    The advise here is excellent. I have figured the priority here is losing weight. I was just going to wait until I finish school in May to start exercising (so I could join a gym----I'm broke right now)but walking or jogging doesn't involve a gym membership. I think I could cure most of this just by losing the weight. I'll still schedule that appointment with my PCP, though. I'm very interested in having that sleep study done. I just wake up too many times during the night to get enough quality sleep. I mean the only way I can have a descent night's sleep is if I'm to the point of complete exhaustion and then I just basically passout on the bed. And no, I don't smoke. I'm glad I never started. Anyways, thanks for the responses. This has been a HUGE help in convincing me to do something about the problem. I appreciate the concern.
  14. Visit  Tenesma profile page
    0
    ignore the post about the concern regarding starting CPAP at a young age... there is nothing wrong with starting CPAP at any age... I have prescribed it for 14 year olds... of course the ideal management is either surgical reduction of airway obstruction (if that is the cause) or weight loss (most common issue)... my major concern in patients that are in your boat is the remodeling of pulmonary and right heart vasculature, this over time can lead to pulmonary hypertension and eventually right heart failure (we are talking many, many years from now)
    Last edit by Tenesma on Mar 10, '04


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