A nurse is preparing to measure a client's oxygen saturation and notes edema of the client's hands and thickened toenails. The nurse should apply the pulse oximeter probe to which of the following locations?

Toe

Skin fold

Earlobe

Finger

Answer and Explanation

The Correct Answer is C

A.   The toe could also be affected by the edema leading to inaccurate reading.
B.   Placing the pulse oximeter probe on a skin fold is not recommended. Skin folds can obscure proper positioning of the probe and interfere with accurate readings. Additionally, skin folds may not adequately represent blood flow and oxygenation levels compared to other sites.
C.   This location is recommended because it is usually free of the issues that can affect the extremities, such as poor circulation or changes in peripheral perfusion, and can provide a more reliable saturation reading.
D.   The finger is the most common site for applying a pulse oximeter probe due to its accessibility and reliability. However, in cases where the fingers are not suitable, such as when there is significant edema or thickened toenails, alternative sites like the toe may be preferred.

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Correct Answer is B

Explanation

A. Standing with feet close together reduces the base of support, making the nurse less stable and increasing the risk of losing balance or straining muscles. It is not recommended for lifting because it compromises stability and balance.
B. Keeping the box close to the body reduces the leverage and strain on the back muscles. This technique utilizes the strength of the legs and core muscles more effectively and helps to maintain balance and stability while lifting.
C. Bending at the waist puts excessive strain on the lower back muscles and can lead to back injury, especially when lifting heavy objects. The correct technique is to bend at the knees and hips while keeping the back straight to maintain proper alignment and reduce strain on the spine.
D. Twisting while lifting or carrying heavy objects can strain the muscles and ligaments of the spine, leading to injury, particularly to the intervertebral discs. The nurse should avoid twisting and instead pivot the entire body with the feet to change direction.

A. Excessive pulmonary secretions B. Cracks in oral mucous membranes C. Tachycardia D. Poor skin turgor

Correct Answer is B

Explanation

A. Excessive pulmonary secretions can be a sign of airway irritation or infection rather than a direct adverse effect of oxygen therapy. It may warrant further assessment and intervention, but it is not typically attributed to oxygen therapy itself.
B. Dryness and cracking of oral mucous membranes can occur as a result of oxygen therapy. Oxygen delivered at higher concentrations or for prolonged periods can dry out mucous membranes, leading to discomfort and potential cracking.
C. Tachycardia (an elevated heart rate) can occur as a compensatory response to hypoxia or increased metabolic demands rather than as a direct adverse effect of oxygen therapy. However, if oxygen therapy leads to an overcorrection of hypoxemia, it could potentially contribute to changes in heart rate.
D. Poor skin turgor is typically a sign of dehydration or fluid imbalance, not directly related to oxygen therapy. It may be important to assess fluid status in clients receiving oxygen therapy, but poor skin turgor itself is not an adverse effect of oxygen administration.

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A nurse is preparing to measure a client's oxygen saturation and notes edema of the client's hands and thickened toenails. The nurse should apply the pulse oximeter probe to which of the following locations?

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