{"id":917,"date":"2017-10-05T15:47:07","date_gmt":"2017-10-05T19:47:07","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/what-are-normal-oxygen-saturation-levels\/"},"modified":"2026-06-17T15:28:48","modified_gmt":"2026-06-17T19:28:48","slug":"what-are-normal-oxygen-saturation-levels","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/chapter\/what-are-normal-oxygen-saturation-levels\/","title":{"raw":"Oxygen Saturation Levels","rendered":"Oxygen Saturation Levels"},"content":{"raw":"Normal oxygen saturation ranges from <strong>97\u2013100%<\/strong> (OER #1) in a healthy individual. However, there are reasons why a lower range occurs and in some cases, why it is sometimes acceptable.\r\n\r\nOlder adults typically have lower oxygen saturation levels than younger adults. For example, someone older than 70 years of age may have an oxygen saturation level of about 95%, which is an acceptable level.\r\n\r\nIt is important to note that the oxygen saturation level <strong>varies<\/strong> considerably based on a person\u2019s state of health. Thus, it is important to understand both <strong>baseline readings<\/strong> and <strong>underlying physiology<\/strong>\u00a0associated with certain conditions to interpret oxygen saturation levels and changes in these levels.\r\n<ul>\r\n \t<li>People who are obese and\/or have conditions such as lung and cardiovascular diseases, emphysema, chronic obstructive pulmonary disease, congenital heart disease and sleep apnea tend to have lower oxygen saturation levels.<\/li>\r\n \t<li>Smoking can influence the accuracy of pulse oximetry in which the the SpO2 is low or falsely high depending on whether hypercapnia is present. With hypercapnia, it is difficult for the pulse oximeter to differentiate oxygen in the blood from carbon monoxide (caused by smoking).<\/li>\r\n \t<li>Oxygen saturation levels may decrease slightly when a person is talking.<\/li>\r\n \t<li>Oxygen saturation may remain normal (e.g., 97% and higher) for people with anemia. However, this may not indicate adequate oxygenation because there are less hemoglobin to carry an adequate supply of oxygen for people who have anemia. The inadequate supply of oxygen may be more prominent during activity for people with anemia.<\/li>\r\n \t<li>Falsely low oxygen saturation levels may be associated with hypothermia, decreased peripheral perfusion, and cold extremities. In these cases, an ear lobe pulse oximeter device or arterial blood gases would provide a more accurate oxygen saturation level. However, arterial blood gases are usually only taken in critical care or emergency settings.<\/li>\r\n<\/ul>\r\n<div class=\"bcc-box bcc-success\">\r\n<h3><strong>Points to Consider<\/strong><\/h3>\r\nIn practice, such as a hospital setting, the SpO2 range of 92\u2013100% is generally acceptable for most clients. Some experts have suggested that a SpO2 level of at least 90% will prevent hypoxic tissue injury and ensure client safety (Beasley, et al., 2016). However, with children, a saturation that drops below the normal of 97%-100% is always something that you should investigate further. If a client's oxygen saturation levels are low, you should have them sit upright so their lungs can fully expand and then perform a focused respiratory assessment.\r\n\r\n<\/div>\r\n<h5><\/h5>\r\n<div class=\"textbox shaded\">\r\n<h3 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Contextualizing Inclusivity \u2013 Pulse Oximetry Biases<\/strong><\/span><\/h3>\r\nThere are biases ingrained in the technology of pulse oximetry, which results in racial disparities in care. Despite decades of research showing the inherent and systematic racism that is part of pulse oximetry (Hidalgo et al., 2021), practices have been slow to change. This is a serious issue considering that treatment decisions are influenced by pulse oximetry, and hypoxemia can lead to complications including higher mortality rates and organ dysfunction (Wong et al., 2021)\r\n\r\nIn the context of hypoxemia, pulse oximeters have been found to generally overestimate oxygen saturations (Feiner et al., 2007) particularly as the SpO2 lowers to 88%. This overestimation is sometimes described as hidden hypoxemia (Wong et al., 2021) in which the oxygen saturation on a pulse oximeter is higher than an oxygen saturation measured via arterial blood draw. For several years, this overestimation has been particularly greatest in people with darker skin tones (Bickler et al., 2005; Feiner et al., 2007). For example, it has been noted that hypoxemia is detected (via pulse oximetry) less in Black patients than white patients (Sjoding et al., 2020). In a large, multi-site study with over 79,000 patients, it was found that hidden hypoxemia was found more in Black patients followed by Hispanic and then similar rates for Asian and white patients (Wong et al., 2021). In another study in the context of COVID-19, hidden hypoxemia was found more in Asian, Black and Hispanic patients than white patients and significantly affected treatment in Black and Hispanic patients (Fawzy et al., 2022).\r\n\r\nAs you go into practice, keep in mind that you should critically reflect on your pulse oximetry findings. For example, if the client\u2019s SpO2 finding is normal, but they are presenting with difficulty breathing or signs of respiratory distress (e.g., shortness of breath, audible breathing, [pb_glossary id=\"989\"]tripod position[\/pb_glossary], [pb_glossary id=\"991\"]intercostal tugging\/pulling\/retractions[\/pb_glossary]), consider your priorities of care. First, always believe the patient and then, consider the findings in the context of your subjective assessment and other physical findings. It may be appropriate to advocate for arterial blood gases to be drawn to verify oxygen saturation levels if the patient is having breathing problems and their pulse oximetry findings are normal.\r\n\r\n<\/div>\r\n&nbsp;\r\n\r\n&nbsp;\r\n<div align=\"left\">\r\n<div class=\"textbox textbox--learning-objectives\"><header class=\"textbox__header\">\r\n<h2 class=\"textbox__title\" style=\"text-align: center\">Priorities of Care<\/h2>\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">You want to assess whether a client who has low oxygen saturation levels is in respiratory distress. To determine if a client is in respiratory distress and requires immediate intervention, you should first ask the client if they are having any shortness of breath (difficulty breathing). In addition, you should observe for any altered level of consciousness (confusion, lethargy) and increased work of breathing such as tachypnea, nasal flaring, audible sounds when breathing (e.g., gasping for air), accessory muscle use (e.g., neck and abdominal muscles), and intercostal retractions (when the skin pulls in between the ribs). If the client shows signs of respiratory distress, stay with client and call for assistance (a senior nurse, physician, or nurse practitioner).\u00a0<\/span><\/p>\r\n\r\n<ul style=\"text-align: left\">\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">If an airway is not patent, try to open the airway with a head-tilt-chin-lift and inspect the mouth and nose for obstructions.<\/span><\/li>\r\n \t<li style=\"font-weight: 400\"><span style=\"color: #000000\">Supplemental oxygen can be applied if there are<strong> [pb_glossary id=\"382\"]standing orders[\/pb_glossary]<\/strong> on your unit.<\/span><\/li>\r\n<\/ul>\r\n<p style=\"text-align: left\"><span style=\"color: #000000\">You may need to keep the client in a supine position if you suspect that they are deteriorating quickly and may go into respiratory or cardiac arrest. Notify the <strong>[pb_glossary id=\"384\"]critical care response team (CCRT)[\/pb_glossary] <\/strong>or call a code in this case. <strong>[pb_glossary id=\"386\"]Bag-mask-ventilation[\/pb_glossary]<\/strong> may be needed if the client is in respiratory arrest.<\/span><\/p>\r\nIf you suspect the client is choking, stay with the client and call for help while you place them in a high fowlers position. If they are able to, encourage them to cough and clear their airway. You may need to suction the oral cavity and airway, if possible. If you suspect a complete obstruction, use a combination of \"back blows, abdominal thrusts, and chest thrusts\" (Canadian Red Cross - https:\/\/www.redcross.ca\/blog\/2021\/9\/what-to-do-if-an-adult-is-choking)\r\n\r\n<span style=\"color: #000000\">However, it is important to consider contextual variables. IF the client has low oxygen saturation levels, but shows no other signs of respiratory distress, take some time to consider why the oxygen saturation levels are low. If oxygen saturations are low, try some less urgent interventions such as waking them up if they are sleeping, have them sit upright so their lungs can fully expand, and ask them to take a few deep breaths. <\/span>\r\n\r\n<\/div>\r\n<\/div>\r\n<\/div>\r\n<h5>Please answer the four questions in the following question set.<\/h5>\r\n<div id=\"h5p-68\"><span>[h5p id=\"178\"]<\/span><\/div>\r\n&nbsp;\r\n\r\n<strong>References<\/strong>\r\n\r\nBickler, P., Feiner, J., &amp; Severinghaus, J. (2005). Effects of skin pigmentation on pulse oximeter accuracy at low saturation. Anesthesiology, 102(4), 715-719.\r\n\r\nFawzy, A., Wu, T., Wang, K., Robinson, M., Farha, J., Bradke, A., Golden, S., Xu, Y. &amp; Garibaldi, B. (2022). Racial and ethnic discrepancy in pulse oximetry and delayed identification of treatment eligibility among patients with COVID-19. JAMA Internal Medicine, 182(7), 730-738.\r\n\r\nFeiner, J., Severinghaus, J., &amp; Bickler, P. (2007). Dark skin decreases the accuracy of pulse oximeters at low oxygen saturation: the effects of oximeter probe type and gender. Anesth Analg, 105(6)(suppl):S18-S23.\r\n\r\nHidalgo, D., Olusanya, O., &amp; Harlan, (2021). Critical care trainees call for pulse oximetry reform. The Lancet: Respiratory Medicine, 9(4), e37.\r\n\r\nSjoding, M., Dickson, R., Iwashyna, T., Gay, S., &amp; Valley, T. (2020). Racial bias in pulse oximetry measurement. New England Journal of Medicine, 383, 2477-2478.\r\n\r\nWong, A., Charpignon, M., Kim, H., Josef, C., de Hond, A., Fojas, J., Tabaie, A., Liu, X., Mireles-Cabodevila, E., Carvalho, L., Kamaleswaran, R., Madushani, R., Adhikari, L., Holder, A., Steyerberg, E., Buchman, T., Lough, M., &amp; Celi, L. (2021). Analysis of discrepancies between pulse oximetry and arterial oxygen saturation measurements by race and ethnicity and association with organ dysfunction and mortality. JAMA Network Open, 4(11).\r\n\r\n____________________________________________________\r\nPart of this content was adapted from OER #1 (as noted in brackets above):\r\n\u00a9 2015 British Columbia Institute of Technology (BCIT). Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon, British Columbia Institute of Technology. Licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. Download this book for free at <a href=\"http:\/\/open.bccampus.ca\" target=\"_blank\" rel=\"noopener\">http:\/\/open.bccampus.ca<\/a>","rendered":"<p>Normal oxygen saturation ranges from <strong>97\u2013100%<\/strong> (OER #1) in a healthy individual. However, there are reasons why a lower range occurs and in some cases, why it is sometimes acceptable.<\/p>\n<p>Older adults typically have lower oxygen saturation levels than younger adults. For example, someone older than 70 years of age may have an oxygen saturation level of about 95%, which is an acceptable level.<\/p>\n<p>It is important to note that the oxygen saturation level <strong>varies<\/strong> considerably based on a person\u2019s state of health. Thus, it is important to understand both <strong>baseline readings<\/strong> and <strong>underlying physiology<\/strong>\u00a0associated with certain conditions to interpret oxygen saturation levels and changes in these levels.<\/p>\n<ul>\n<li>People who are obese and\/or have conditions such as lung and cardiovascular diseases, emphysema, chronic obstructive pulmonary disease, congenital heart disease and sleep apnea tend to have lower oxygen saturation levels.<\/li>\n<li>Smoking can influence the accuracy of pulse oximetry in which the the SpO2 is low or falsely high depending on whether hypercapnia is present. With hypercapnia, it is difficult for the pulse oximeter to differentiate oxygen in the blood from carbon monoxide (caused by smoking).<\/li>\n<li>Oxygen saturation levels may decrease slightly when a person is talking.<\/li>\n<li>Oxygen saturation may remain normal (e.g., 97% and higher) for people with anemia. However, this may not indicate adequate oxygenation because there are less hemoglobin to carry an adequate supply of oxygen for people who have anemia. The inadequate supply of oxygen may be more prominent during activity for people with anemia.<\/li>\n<li>Falsely low oxygen saturation levels may be associated with hypothermia, decreased peripheral perfusion, and cold extremities. In these cases, an ear lobe pulse oximeter device or arterial blood gases would provide a more accurate oxygen saturation level. However, arterial blood gases are usually only taken in critical care or emergency settings.<\/li>\n<\/ul>\n<div class=\"bcc-box bcc-success\">\n<h3><strong>Points to Consider<\/strong><\/h3>\n<p>In practice, such as a hospital setting, the SpO2 range of 92\u2013100% is generally acceptable for most clients. Some experts have suggested that a SpO2 level of at least 90% will prevent hypoxic tissue injury and ensure client safety (Beasley, et al., 2016). However, with children, a saturation that drops below the normal of 97%-100% is always something that you should investigate further. If a client&#8217;s oxygen saturation levels are low, you should have them sit upright so their lungs can fully expand and then perform a focused respiratory assessment.<\/p>\n<\/div>\n<h5><\/h5>\n<div class=\"textbox shaded\">\n<h3 style=\"text-align: center\"><span style=\"color: #000000\"><strong>Contextualizing Inclusivity \u2013 Pulse Oximetry Biases<\/strong><\/span><\/h3>\n<p>There are biases ingrained in the technology of pulse oximetry, which results in racial disparities in care. Despite decades of research showing the inherent and systematic racism that is part of pulse oximetry (Hidalgo et al., 2021), practices have been slow to change. This is a serious issue considering that treatment decisions are influenced by pulse oximetry, and hypoxemia can lead to complications including higher mortality rates and organ dysfunction (Wong et al., 2021)<\/p>\n<p>In the context of hypoxemia, pulse oximeters have been found to generally overestimate oxygen saturations (Feiner et al., 2007) particularly as the SpO2 lowers to 88%. This overestimation is sometimes described as hidden hypoxemia (Wong et al., 2021) in which the oxygen saturation on a pulse oximeter is higher than an oxygen saturation measured via arterial blood draw. For several years, this overestimation has been particularly greatest in people with darker skin tones (Bickler et al., 2005; Feiner et al., 2007). For example, it has been noted that hypoxemia is detected (via pulse oximetry) less in Black patients than white patients (Sjoding et al., 2020). In a large, multi-site study with over 79,000 patients, it was found that hidden hypoxemia was found more in Black patients followed by Hispanic and then similar rates for Asian and white patients (Wong et al., 2021). In another study in the context of COVID-19, hidden hypoxemia was found more in Asian, Black and Hispanic patients than white patients and significantly affected treatment in Black and Hispanic patients (Fawzy et al., 2022).<\/p>\n<p>As you go into practice, keep in mind that you should critically reflect on your pulse oximetry findings. For example, if the client\u2019s SpO2 finding is normal, but they are presenting with difficulty breathing or signs of respiratory distress (e.g., shortness of breath, audible breathing, <button class=\"glossary-term\" aria-describedby=\"917-989\">tripod position<\/button>, <button class=\"glossary-term\" aria-describedby=\"917-991\">intercostal tugging\/pulling\/retractions<\/button>), consider your priorities of care. First, always believe the patient and then, consider the findings in the context of your subjective assessment and other physical findings. It may be appropriate to advocate for arterial blood gases to be drawn to verify oxygen saturation levels if the patient is having breathing problems and their pulse oximetry findings are normal.<\/p>\n<\/div>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<div style=\"text-align: left;\">\n<div class=\"textbox textbox--learning-objectives\">\n<header class=\"textbox__header\">\n<h2 class=\"textbox__title\" style=\"text-align: center\">Priorities of Care<\/h2>\n<\/header>\n<div class=\"textbox__content\">\n<p style=\"text-align: left\"><span style=\"color: #000000\">You want to assess whether a client who has low oxygen saturation levels is in respiratory distress. To determine if a client is in respiratory distress and requires immediate intervention, you should first ask the client if they are having any shortness of breath (difficulty breathing). In addition, you should observe for any altered level of consciousness (confusion, lethargy) and increased work of breathing such as tachypnea, nasal flaring, audible sounds when breathing (e.g., gasping for air), accessory muscle use (e.g., neck and abdominal muscles), and intercostal retractions (when the skin pulls in between the ribs). If the client shows signs of respiratory distress, stay with client and call for assistance (a senior nurse, physician, or nurse practitioner).\u00a0<\/span><\/p>\n<ul style=\"text-align: left\">\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">If an airway is not patent, try to open the airway with a head-tilt-chin-lift and inspect the mouth and nose for obstructions.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"color: #000000\">Supplemental oxygen can be applied if there are<strong> <button class=\"glossary-term\" aria-describedby=\"917-382\">standing orders<\/button><\/strong> on your unit.<\/span><\/li>\n<\/ul>\n<p style=\"text-align: left\"><span style=\"color: #000000\">You may need to keep the client in a supine position if you suspect that they are deteriorating quickly and may go into respiratory or cardiac arrest. Notify the <strong><button class=\"glossary-term\" aria-describedby=\"917-384\">critical care response team (CCRT)<\/button> <\/strong>or call a code in this case. <strong><button class=\"glossary-term\" aria-describedby=\"917-386\">Bag-mask-ventilation<\/button><\/strong> may be needed if the client is in respiratory arrest.<\/span><\/p>\n<p>If you suspect the client is choking, stay with the client and call for help while you place them in a high fowlers position. If they are able to, encourage them to cough and clear their airway. You may need to suction the oral cavity and airway, if possible. If you suspect a complete obstruction, use a combination of &#8220;back blows, abdominal thrusts, and chest thrusts&#8221; (Canadian Red Cross &#8211; https:\/\/www.redcross.ca\/blog\/2021\/9\/what-to-do-if-an-adult-is-choking)<\/p>\n<p><span style=\"color: #000000\">However, it is important to consider contextual variables. IF the client has low oxygen saturation levels, but shows no other signs of respiratory distress, take some time to consider why the oxygen saturation levels are low. If oxygen saturations are low, try some less urgent interventions such as waking them up if they are sleeping, have them sit upright so their lungs can fully expand, and ask them to take a few deep breaths. <\/span><\/p>\n<\/div>\n<\/div>\n<\/div>\n<h5>Please answer the four questions in the following question set.<\/h5>\n<div id=\"h5p-68\"><span><\/p>\n<div id=\"h5p-178\">\n<div class=\"h5p-iframe-wrapper\"><iframe id=\"h5p-iframe-178\" class=\"h5p-iframe\" data-content-id=\"178\" style=\"height:1px\" src=\"about:blank\" frameBorder=\"0\" scrolling=\"no\" title=\"Ch4NO2QuestionSet\"><\/iframe><\/div>\n<\/div>\n<p><\/span><\/div>\n<p>&nbsp;<\/p>\n<p><strong>References<\/strong><\/p>\n<p>Bickler, P., Feiner, J., &amp; Severinghaus, J. (2005). Effects of skin pigmentation on pulse oximeter accuracy at low saturation. Anesthesiology, 102(4), 715-719.<\/p>\n<p>Fawzy, A., Wu, T., Wang, K., Robinson, M., Farha, J., Bradke, A., Golden, S., Xu, Y. &amp; Garibaldi, B. (2022). Racial and ethnic discrepancy in pulse oximetry and delayed identification of treatment eligibility among patients with COVID-19. JAMA Internal Medicine, 182(7), 730-738.<\/p>\n<p>Feiner, J., Severinghaus, J., &amp; Bickler, P. (2007). Dark skin decreases the accuracy of pulse oximeters at low oxygen saturation: the effects of oximeter probe type and gender. Anesth Analg, 105(6)(suppl):S18-S23.<\/p>\n<p>Hidalgo, D., Olusanya, O., &amp; Harlan, (2021). Critical care trainees call for pulse oximetry reform. The Lancet: Respiratory Medicine, 9(4), e37.<\/p>\n<p>Sjoding, M., Dickson, R., Iwashyna, T., Gay, S., &amp; Valley, T. (2020). Racial bias in pulse oximetry measurement. New England Journal of Medicine, 383, 2477-2478.<\/p>\n<p>Wong, A., Charpignon, M., Kim, H., Josef, C., de Hond, A., Fojas, J., Tabaie, A., Liu, X., Mireles-Cabodevila, E., Carvalho, L., Kamaleswaran, R., Madushani, R., Adhikari, L., Holder, A., Steyerberg, E., Buchman, T., Lough, M., &amp; Celi, L. (2021). Analysis of discrepancies between pulse oximetry and arterial oxygen saturation measurements by race and ethnicity and association with organ dysfunction and mortality. JAMA Network Open, 4(11).<\/p>\n<p>____________________________________________________<br \/>\nPart of this content was adapted from OER #1 (as noted in brackets above):<br \/>\n\u00a9 2015 British Columbia Institute of Technology (BCIT). Clinical Procedures for Safer Patient Care by Glynda Rees Doyle and Jodie Anita McCutcheon, British Columbia Institute of Technology. Licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted. Download this book for free at <a href=\"http:\/\/open.bccampus.ca\" target=\"_blank\" rel=\"noopener\">http:\/\/open.bccampus.ca<\/a><\/p>\n<div class=\"glossary\"><div class=\"glossary__tooltip\" id=\"917-989\" hidden><p>is leaning forward with hands and\/or forearms resting on their legs or another surface such as a table.<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"917-991\" hidden><p>are when the muscles in between the ribs are sucked inward when breathing.<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"917-382\" hidden><p>are written protocols that authorize designated members of the health care team (e.g., nurses) to complete certain tasks (e.g., apply oxygen) without a physician order.<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"917-384\" hidden><p>is an interdisciplinary group of practitioners trained in critical care and have expertise in assessing and intervening during code or pre-code situations when a client is deteriorating.<\/p>\n<\/div><div class=\"glossary__tooltip\" id=\"917-386\" hidden><p>refers to a mask that fits over the mouth\/nose during an emergency situation and is attached to a self-inflating bag with 100% oxygen that is squeezed to ventilate the lungs.<\/p>\n<\/div><\/div>","protected":false},"author":34,"menu_order":13,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":"cc-by-nc"},"chapter-type":[49],"contributor":[84,80,81,83,82],"license":[56],"class_list":["post-917","chapter","type-chapter","status-publish","hentry","chapter-type-numberless","contributor-andy-tan","contributor-jennifer-l-lapum","contributor-margaret-verkuyl-iojpniovfw","contributor-oona-st-amant-qmby8ihl0i","contributor-wendy-garcia-xwldzusnjr","license-cc-by-nc"],"part":873,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/917","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/users\/34"}],"version-history":[{"count":9,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/917\/revisions"}],"predecessor-version":[{"id":4036,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/917\/revisions\/4036"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/parts\/873"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapters\/917\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/media?parent=917"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/pressbooks\/v2\/chapter-type?post=917"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/contributor?post=917"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/assessmentnursingmain\/wp-json\/wp\/v2\/license?post=917"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}