what would you have done??

[ajaxgirl]

LTC resident, 60 yrs old, no resp issues, has down's syndrome, no HX of sleep apnea

No CPR, but is to be transferred to hospital-as per care directives

During night shift her breathing looks erratic, she is sleeping but resps are labored. they seem to stop then restart. They stop for a few seconds then a loud snore, then restart. She is using accessory muscles to breathe. This is not normal for her. All VS are normal-resps are 18 but they are slow, then fast. She has had a cough for a few days, chest sounds ok.

O2 SAT was variable. Depending on resps it ranged from 79-95. Her normal sats are 95%.

What would you have done???

[Nascar nurse, ASN, RN]

LTC resident, 60 yrs old, no resp issues, has down's syndrome, no HX of sleep apnea

No CPR, but is to be transferred to hospital-as per care directives

During night shift her breathing looks erratic, she is sleeping but resps are labored. they seem to stop then restart. They stop for a few seconds then a loud snore, then restart. She is using accessory muscles to breathe. This is not normal for her. All VS are normal-resps are 18 but they are slow, then fast. She has had a cough for a few days, chest sounds ok.

O2 SAT was variable. Depending on resps it ranged from 79-95. Her normal sats are 95%.

What would you have done???

It appears the biggest concern is what the oximeter reading is, which would make my FIRST instinct to recheck the SAT rate w/ another machine, especially since vital signs are all normal.

One of my favorite Dr's taught me when I was a brand new nurse "Always ask yourself before you panic.. "Does he/she LOOK sick (in distress) of some kind". Don't ever use just a machine to tell you how sick someone is.

I would have rechecked SAT on different machine, put head of bed up, put oxygen on, determined if LOC is different than usual, checked nailbeds. From the OP, I'm not sure this was really a big deal - maybe undiagnosised sleep apnea?

[MS._Jen_RN, ASN, RN]

maybe undiagnosised sleep apnea?

I'd be inclined to agree, possible new dx. Or, if you read the article nitemare posted, possible that. In eigther instance I wouldn't have panicked, possible asked for a sleep study.

[Super Nurf]

The low 02 sats would have concerned me. I would have tried whatever intervention I could and if they did not come up, I would call the snoopervisor on, and per his/her advice then call or not call the dr at that point in time. I would then make sure the day shift was well aware and would make the MD aware if it was something new, and chart exactly what I saw and what I did.