a question about a low oxygen saturation

[nurse41383]

I have a question about a patient that had a normal oxygen saturation in the am taken by the tech. In the after noon it showed an oxgen sat of 82% pt asymptomatic all other vs wnl RR 16. Pt had acrylic nails and painted. I rechecked took nail polish off. Monitor was bouncing around then hit 88 still pt denied sob lungs clear rr16. The pt was on a morphine pca but not at all drowsy. S/p surgery pt pod#2. Put pt on 2l o2 anyway head up. Called respiratory thinking equipment not reading right. Resp equipment showed same and agbs showed 74%. Ended up transferring pt to another unit but I'm confounded on what might have happened. Tele even showed sr??????

[akulahawkRN, ADN, RN, EMT-P]

I have a question about a patient that had a normal oxygen saturation in the am taken by the tech. In the after noon it showed an oxgen sat of 82% pt asymptomatic all other vs wnl RR 16. Pt had acrylic nails and painted. I rechecked took nail polish off. Monitor was bouncing around then hit 88 still pt denied sob lungs clear rr16. The pt was on a morphine pca but not at all drowsy. S/p surgery pt pod#2. Put pt on 2l o2 anyway head up. Called respiratory thinking equipment not reading right. Resp equipment showed same and agbs showed 74%. Ended up transferring pt to another unit but I'm confounded on what might have happened. Tele even showed sr??????

Do you know the CO2 level? You said lungs were clear, how much volume was being moved?

[nurse41383]

No I cannot remember.

[cayenne06, MSN, CNM]

did she have an obstructive pulmonary disorder? These patients can become accustomed to low O2/ high CO2 and not show the degree of s/s that we might expect.

[nurse41383]

No hx of pulmonary conditions only carotid stenosis

[Esme12, ASN, BSN, RN]

What was the surgery for?

[nurse41383]

Ankle fx

[MeganB1983]

Was she using her incentive spirometer?

[tokmom, BSN, RN]

Did you move the monitor to the ear or toe?

I would certainly been monitoring ABG.

Do you know baseline?