The patient with congestive heart failure has oxygen prescribed as needed. In which of the following situations would oxygen be needed to prevent hypoxemia in the patient?
1. conducting passive range of motion on the patient
2. having a quiet conversation with a clergy member
3. assisting the patient with self-care activities
4. while taking a midday nap.
3
Rationale: The patient needs additional oxygen when doing any activity that increases the work of the heart. Hypoxemia is a negative inotrope and will reduce the contractility of the heart. When the patient is at rest, the load on the heart would decrease and, therefore, the need for oxygen would decrease. Having a quiet conversation with a clergy member and having passive range of motion will also not increase the oxygen demands on the heart or cause hypoxemia.
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