Pulse Oximetry Flashcards by Katelyn Odom

Painless and noninvasive procedure. Used to measure oxygen saturation of hemoglobin in arterial blood. Most often used for ‘spot-check’ measurement of oxygen saturation (single measurement). Occasionally used for short-term continuous monitoring such as patients experiencing an asthmatic attack and sedated patient during minor office surgery.

Pulse Oximetry

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Complex compound found in red blood cells. What is this? What is its function?

Hemoglobin
Function: transports oxygen

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What provides information about cardiorespiratory status (amount of oxygen being delivered to tissues) and absorbs red light from LED?

Pulse oximetry

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Computerized device. Measures oxygen saturation. Consists of a clip-like probe connected to a monitor. Also measures pulse rate in beats/min. Beep is emitted with each pulse beat.

Pulse oximeter

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Probe attached to peripheral pulsating capillary bed called the what?

Fingertip

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Transmits infrared light and red light through tissues to a photodetector (light detector)

Light-emitting diode (LED)

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High oxygen content (oxygen-rich). Absorbs infrared light from LED.

Bright red hemoglobin

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Low in oxygen (oxygen poor)

Dark red hemoglobin

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Calculates light transmitted from oxygen-rich and oxygen-poor hemoglobin. From this ratio, oxygen saturation of hemoglobin is determined–measurement converted to a percentage; displayed on screen of the monitor.

Computer of oximeter

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Saturation of peripheral oxygen. Pulse oximeter measures oxygen saturation of peripheral capillaries. Abbreviation used when pulse oximeter is used to measure the oxygen saturation level.

SpO2

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Saturation of arterial oxygen. Abbreviation used when arterial blood gas (ABG) analysis is used to measure the oxygen saturation level

SaO2

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Represents percentage of Hgb saturated with oxygen.

Pulse oximetry reading

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Each molecule of Hgb can carry how many oxygen molecules? 110 molecules of Hgb fully saturated with oxygen; carrying 400 molecules of oxygen makes oxygen saturation reading:100%.
- 100 molecules of Hgb carrying 360 molecules of oxygen—oxygen saturation reading: 90%

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The more hemoglobin saturated with oxygen, the lower or higher the oxygen saturation?

higher

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What is the range of oxygen saturation of healthy individuals? Air is only what percent saturation with oxygen?

95%-99%
- 21%

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True or False?
Unusual for hemoglobin to be 100% saturated with oxygen. Patents on supplemental oxygen may have a reading of 100%.

True

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What could the percentage of oxygen saturation be if it is classified as an inadequate amount of oxygen reaching the tissues? Some patients with chronic pulmonary disease are able to tolerate lower saturation levels.

less than 95%

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Respiratory failure resulting in tissue damage is seen with people who have what range of oxygen saturation?
-What about when cyanosis appears?
What percentage is life threatening?

85%-90%
- 75%
- oxygen saturation below 70%

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Decrease in the oxygen saturation of the blood (less than 95%). Can lead to hypoxia.

Hypoxemia

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A reduction in the oxygen supply to tissues. If not treated, tissues damage and death. Symptoms: headache, mental confusion, nausea, dizziness, shortness of breath, and tachycardia. Tissues most sensitive to this; brain, heart, pulmonary vessels, and liver

Hypoxia

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Performed on patients complaining of respiratory problems (ex. dyspnea). Decreased SpO2 reading (along with further testing and clinical signs and symptoms). Assists physician in diagnosis and treatment. May include drug therapy and oxygen therapy.

Purpose of Pulse Oximetry

Decreased SpO2 value (hypoxemia) is caused by what? (3)

Acute pulmonary disease (pneumonia)
Chronic pulmonary disease (emphysema, asthma, bronchitis)
Cardiac problems (congestive heart failure, coronary artery disease)

What is pulse oximetry used to assess:

Effectiveness of oxygen therapy
Patient tolerance to activity
Effectiveness of treatment such as bronchodilators
Patient tolerance to analgesia and sedation

Used by most offices, portable and lightweight, and usually battery operated.

Handheld pulse oximeter

Used in a hospital setting. Continuous bedside monitoring of oxygen saturation

Stand-alone oximeter

Turns oximeter on and off

On/off control

Digital display of oxygen saturation. Expressed as a percent. Updated with each pulse beat.

SpO2 % display

Contains controls, indicators, and displays

Monitor

Indicates pulse rate in beats/min. Updated with each pulse beat. Oximeter emits a constant-pitch audible beep with each pulse beat

Pulse rate display

Display of pulse strength. Consists of a segmented display of bars. Stronger the pulse, the more segments light up.

Pulse strength bar graph indicator

Lights when oximeter is searching for pulse

Pulse search indicator

Adjusts the beep that sounds with each pulse beat. Settings: high, low, and off

Adjustable volume control

Warns that battery is getting low. Lights up and sounds an alarm when 30 mins of battery use remain

Low battery indicator

Audible beeps that indicate a problem or condition that may affect the reading. Must not be ignored. Must be corrected before continuing.

Alarm messages

Automatically occurs when oximeter is turned on. Takes approximately 3 to 5 seconds. Oximeter checks its internal systems to make sure it is functioning properly. If problem is detected, alarm sounds and monitor displays an error code. Refer to troubleshooting section of user manual for interpretation of code and action to take

Power-on self test (POST)

Convenient to use, easy to apply, more susceptible to inaccurate readings from patient movement, must be cleaned and disinfected after use

Reusable probes

Expensive to use. Used for long term monitoring of oxygen saturation in the hospital. Made of adhesive bandage-like material. Discarded after use.

Disposable probes

True or False? Use probe designed for oximeter being used. Mixing probes from different manufacturers can result in an inaccurate reading. Probe may be permanently attached to cable or may be a separate device. Requires connection to the cable.

True

What is the most common site for the probe to be attached to? What are other sites that can be used for a reading?

fingertip - toe and earlobe

Never lift or carry the monitor by the cable which could:

- Damage the cable connections Cause cable to disconnect from monitor causing monitor to fall on floor or fall on patient

Alignment of probe may be impossible with:

- Patient with very small finger (thin patient or child) - Patients with very large fingers (obese patients) --- use another site (such as earlobe); pediatric probes can be used with thin patients or children

What colors of nail polish or artificial nails could affect SpO2 reading and light transmission?

blue, black, and green nails

True or False? Use a different site if a patient has artificial nails. Oil dirt, and grim eon fingertip can interfere with proper light transmission. Cleanse site with soap and water and allow to dry. Avoid areas with bruises, burns, stains, or tattoos. Darkly pigmented skin and jaundice (do not affect reading)

Pulse oximeter works best when there is a good strong pulse in finger to which the probe is applied Poor blood flow may cause pulse to be so weak that oximeter cannot do what? What conditions result in poor blood flow? (4)

obtain a reading - Peripheral vascular disease - Vasoconstrictor medications - Severe hypotension - Hypothermia

What site should you use if a patient has poor peripheral blood flow?

Earlobe

Never attach probe to finger of arm to which what is applied? Blood flow to finger cut off when cuff inflates, results in loss of pulse signal.

If there is too much ambient light what can you do to fix it?

- Turning off light - Moving probe away from light source - Covering probe with opaque material (washcloth)

What other sites could you measure if patient movement cannot be eliminated (tremors of hand)?

toe or earlobe

How should you clan monitor and cable?

Clean periodically with damp cloth of warm water and disinfectant cleaner. Make sure cloth is not too wet. To prevent solution from running into monitor—could damage internal components.

How should you clean the probe?

- Clean periodically with soft cloth moistened in water and disinfectant cleaner - Disinfect by wiping thoroughly with an antiseptic wipe and allow to dry - Remove dirt and grime—could interfere with light transmission - Never soak or immerse in liquid solution—would damage probe - Probe is heat-sensitive, cannot be autoclaved - Store pulse oximeter at room temperature in a dry environment