What to Do When Endotracheal Tube Insertion Goes Wrong

Every RN knows the stakes are high when it comes to airway management, especially after inserting an endotracheal tube. It’s a procedure that’s as vital as it is delicate. Now, let’s talk about one crucial scenario when you might need to spring into action: a pulse oximetry reading of 88% following intubation. Yikes, right?

Why does this matter so much? A reading of 88% isn’t just a bad hair day; it’s a glaring red flag in the nursing world. Normal oxygen saturation levels range between 95-100%. So when your patient dips below that, you're looking at hypoxemia—a serious condition that can spiral downward fast.

Think about it: if the oxygen level is low, that could signal a possible disaster. Maybe the endotracheal tube is misplaced (it’s happened before), or there's a bigger respiratory problem bubbling under the surface. Whatever the reason, nursing intervention must be swift and decisive. Immediate actions might include checking tube placement, providing supplemental oxygen, or initiating manual ventilation.

But let’s compare this with other scenarios you could see after intubation. If breath sounds are audible bilaterally, you might breathe a sigh of relief. It means air is making its way to both lungs—phew! Then again, when patients are intubated, they naturally can’t speak—no need to panic there. It’s just part of the intubation process. And mist in the T-Piece? That’s usually a good sign too, indicating humidity—nothing to stress over.

So, next time you’re faced with nursing assessments after endotracheal tube placement, keep your eyes peeled for those pulse oximetry readings. They’re more than just numbers; they’re potential warning signs. If that reading drops, remember—the quicker you act, the better the chances for your patient.

It’s this blend of vigilance and knowledge that truly defines effective nursing. If you're preparing for the HESI Registered Nurse EXIT Exam, keeping these key points in mind will surely give you an edge. Studying beyond textbook definitions and embracing real-world scenarios like this one can make a world of difference come exam day. Take a deep breath—you’ve got this!