Pulse Oximeter

Simple non-invasive method of monitoring the percentage of hemoglobin which is

saturated with oxygen
A quick inexpensive method of assessing oxygenation
- Autonomic blood pressure cuff
- Provides pulse reading

Purposes
Used to detect hypoxia before the patient becomes clinically cyanosed
Used in patients that is sedated for procedure such as endoscopy
Necessary whenever a patients oxygenation may be unstable
Used to measure the oxygen saturation of a patients blood and changes in blood
volume in skin, producing a photoplethysmograph-

Procedure

Choose a sensor appropriate for client’s weight, size, and desired location.
Because weight limits of sensors overlap a pediatric sensor that could be used
for a small adult

Prepare the site, clean the site with alcohol wipe before applying the sensor

Apply the sensor and connect to the pulse oximeter

Set and turn on the alarm when using continuous monitoring

Ensure the clients safety

Ensure the accuracy of measurement

Nursing Consideration
 Infant, if an appropriate sized or toe sensor is not available, consider using an
ear lobe or forehead sensor

The high and low SaO2 are generally present at 95% and 80% for neonates

The high and low pulse rate is usually present at 200 and 100 for neonates

The oximetery must be taped, wrapped with an elastic bandage or covered by

stocking to keep it on place

Children, instruct the child that the sensor, does not hurt. Disconnect the probe
whenever possible to allow for movement

Adult, used of vasoconstrictor medication, poor circulation, thickened nails may

make finger or toe sensor inaccurate

Incentive Spirometry

Also referred to as sustained maximal inspiration device (SMI)

A method of deep breathing that provides visual feedback to encourage the

patient to inhale slowly and deeply to maximize lung inflation, prevent and reduce
atelecstasis

A form of directed therapy

Purposes

To improve pulmonary ventilation

Counteract the effect of anesthesia or hypoventilation

Loosen respiratory gaseous exchange

 Expand collapsed alveoli

Improved inhalation

Used after surgery, especially thoracic and abdominal surgeries

Procedure

Explain the reason and objective for therapy. The inspired air helps to inflate
lungs. The ball or weight in the spirometer will rise in response to the intensity of
the air intake. The higher the ball rises, the deeper the breath

Assess the patient level of pain and administer pain medication if prescribed

Position the patient in SEMI-FOWLERS position or in upright position

Demonstrate how to use diaphragmatic breathing

Instruct the patient to place the mouthpiece of the spirometer firmly in the mouth,
to breathe air in, and to hold the breath at the end of inspiration for about 3
seconds. Then the patient exhale slowly

Encourage the patient to perform the procedure approximately 10 times in

succession, repeating 10 breaths with the spirometer each hour during waking
hours

Set a reasonable volume and repetition goal (to provide encouragement and give
the patient a sense of accomplishment)

Encourage coughing during and after each session

Place the spirometer with easy reach of the patient

Nursing Consideration

Placing the patient in the proper position

Teaching the technique on how to use the incentive spirometer

Setting realistic goals for the patient

Recording the result of the therapy