CNA Certification (Written Exam)Basic Nursing SkillsHard
A nurse aide is measuring a resident's oxygen saturation (SpO2) using a pulse oximeter. The reading is 91%. What is the most appropriate action for the nurse aide to take?
- AReport the reading to the nurse immediately.
- BDocument the reading as normal.
- CAdjust the resident's oxygen therapy without consulting the nurse.
- DRemove the pulse oximeter and recheck in an hour.
Show answer & explanationAnswer & explanation
Correct answer: A. Report the reading to the nurse immediately.
Normal SpO2 for most residents is typically 95-100%. A reading of 91% is below the acceptable range and indicates potential hypoxemia, which requires immediate reporting to the nurse for further assessment and intervention.
Why the other options are wrong
- B. 91% is not a normal SpO2 reading; it is below the acceptable range.
- C. Nurse aides are not permitted to initiate or adjust oxygen therapy; this is outside their scope of practice.
- D. Delaying reporting could be detrimental; the nurse needs to assess promptly.
Low Oxygen Saturation (Hypoxemia)
An SpO2 reading below 95% (typically 90-94% depending on facility policy or baseline) indicates hypoxemia and requires immediate reporting.
- Normal SpO2: 95-100%.
- Below 95% is concerning.
- Below 90% is critical.
- Always report low readings to the nurse.
Memory trick: Oxy-GEN Levels: Good, Low, Report.