Final answer:
In the case of a patient with metastatic lung cancer experiencing a drop in oxygen saturation from 93% to 86%, the priority is to stop the ambulation and provide immediate seating or lying support. The nurse should then obtain a physician's order for supplemental oxygen to address the hypoxemia. Further assessments, including possibly changing the oximetry probe site or ordering arterial blood gases, can follow once the patient's immediate need for oxygen is addressed.
Step-by-step explanation:
When a nurse observes a drop in oxygen saturation from 93% to 86% while ambulating a patient with metastatic lung cancer, it's essential to first address the patient's immediate need for oxygen. Oxygen saturation or percent sat, is critical in assessing a patient's oxygenation status, reflecting the percentage of hemoglobin saturated with oxygen in the blood.
A significant drop, such as the one described, suggests hypoxemia which indicates that the patient is experiencing a deficiency in the amount of oxygen reaching body tissues. A reading below 90% is generally considered concerning and requires intervention.
In this scenario, the most appropriate nursing action is to stop the ambulation immediately. The priority is to assist the patient in returning to a seated or lying position to decrease the work of breathing and to check the patient's overall condition. Following this, the nurse should obtain a physician's order for supplemental oxygen to correct the hypoxemia. Supplemental oxygen can help increase the oxygen saturation level, which is critical in maintaining tissue oxygenation and preventing further deterioration of the patient's condition.
Once the patient is stable and oxygen supplementation commenced, further assessments can be made. There may be a need to re-evaluate the ambulation plan based on the patient's response to it. Obtaining an arterial blood gas may be warranted if there's a persistent concern about the patient's oxygenation and ventilation status or if supplemental oxygen does not bring the saturation up to an acceptable level.
Switching the site of the oximetry probe (for example, to the earlobe) can be considered if there's suspicion of inaccurate readings at the current site, but this should not delay the administration of oxygen.