An elderly patient was recently discharged to home after treatment for chronic heart failure. The patient experiences a pulse rate increase from 80 beats per minute (bpm) to 102 bpm when walking from the kitchen to the utility room to do laundry

Question

What is an appropriate nursing action for the home health nurse? 1. Encourage the patient to complete tasks such as laundry early in the morning before fatigue is an issue.
2. Recommend that the patient ignore the pulse rate and become more active to build stamina.
3. Encourage the patient to rest for 30 minutes between completing each load of laundry.
4. Encourage the patient to sit and rest in the utility room and whenever the patient feels the pulse rate increase.

Answer 1

4
Rationale 1: Doing all the laundry in the morning will not help in this particular situation.
Rationale 2: The patient should not ignore this signal that the heart is working too hard.
Rationale 3: The issue is with walking to the utility room, not with the actual work associated with doing the laundry.
Rationale 4: The increase in pulse rate indicates that activity is not being tolerated. Rest should help bring the heart rate down to the pre-activity level.