Intervention question

[amyliz23]

I'm a student and am wondering about a question that may seem to have a simpke answer, but I'm unsure about it anyway.

If you have a pt on 2L/min o2 and an order to keep him >94%... and during morning assessment, his spo2 is at 89%, what would be the appropriate nursing intervention???

One of my cohorts said to advise cough and deep breathing. Another says to raise the o2 to 4L/min. Are one of these correct, or neither??

[traumaRUs, MSN, APRN]

Moved to nursing student assistance

[NICUismylife, ADN, BSN, RN]

What do YOU think of those answers? We tend to not just blurt out answers, but help you reach the correct answer. If you provide your personal feedback to your friends' responses, then we can tell you if you're on the right path, or point you in the right direction.

[amyliz23]

Awesome!

Well re: the coughing and deep breathing, it may be all that is necessary. Maybe the patient wasn't breathing effectively? And perhaps increasing the o2 would be unnecessary at this point? My issue is- isn't 89% pretty low to just try this? I almost feel that auscultating the lungs would be a better answer then to have them cough, becauae you'd want to quickly pinpoint if there were an issue.

Now with increasing the o2 to 4L/min, I thought this was the best answer, thinking it would be the quickest way to increase the pts spo2., since its ordered as such. However, it doesn't assess if there is a reason why the pts spo2 was at 89% while already on 2L.

Ugh... this critical thinking thing is fun, but tough!

[vanilla bean]

Now with increasing the o2 to 4L/min, I thought this was the best answer, thinking it would be the quickest way to increase the pts spo2., since its ordered as such. However, it doesn't assess if there is a reason why the pts spo2 was at 89% while already on 2L.

Ugh... this critical thinking thing is fun, but tough!

Good job exercising those critical thinking skills and your reasoning through the question. You are correct that it is important to try to identify the reason for the abnormal finding. Yes, increasing the O2 might be the *quickest* way to bring the SpO2 up, but is that extra O2 what's really needed? Often, asking a patient to deep breathe and cough is the perfect solution; maybe they're shallow breathing due to post-op pain, or because they were asleep when you discover the 89% SpO2 (you mentioned that this was a morning assessment), or because they need to clear some early morning secretions, etc. Sometimes, just boosting a patient up in bed will resolve the problem if they've slid down in bed or slumped over slightly. Think *nursing* interventions before *medical* interventions.

[amyliz23]

Thank you! That makes so much sense. I'm very glad I asked and I'm even more appreciative of your response! Thank you for taking the time to help.