A nurse is obtaining an oxygen saturation on a client. Which of the following actions should the nurse take?
Choose a finger with a capillary refill less than 2 sec.
Place the sensor probe on the same extremity as an electronic blood pressure cuff.
Wait 10 sec after placing the probe before obtaining the oxygen saturation reading.
Relocate the sensor every 8 hrs.
The Correct Answer is A
The nurse should choose a finger with good circulation, as indicated by a capillary refill time of less than 2 seconds, to obtain an accurate oxygen saturation reading.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
- Remove protective gown before removing gloves.
When caring for a client with Clostridium Difficile, it is important to follow strict contact precautions to prevent the spread of the bacteria. The nurse should remove the protective gown before removing gloves to avoid contaminating the gown with any bacteria that may be on the gloves. This helps to minimize the risk of spreading the bacteria to other clients or healthcare workers.
- Shake bed linens before placing them in a linen bag.
Shaking bed linens can cause any bacteria that may be on them to become airborne, increasing the risk of spreading the bacteria to other surfaces. Instead, bed linens should be rolled up and placed directly into a linen bag without shaking them.
- Use an electronic thermometer to take the client's temperature.
An electronic thermometer is preferred when taking the temperature of a client with Clostridium Difficile because it can be easily disinfected between uses, reducing the risk of spreading the bacteria.
- Remove protective gloves when leaving the client's room.
Protective gloves should be removed before leaving the client's room to avoid contaminating other surfaces or spreading the bacteria to other clients or healthcare workers.
Correct Answer is A
Explanation
Localized warmth is a classic sign of inflammation and can indicate the presence of an infection or injury in the affected area. Sanguineous drainage is a type of wound drainage that consists of blood and is not a sign of inflammation. Palpable pedal pulses and full range of motion can provide information about the injury, but they are not specific to inflammation. Therefore, options b, c, and d are incorrect.
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