A nurse is caring for a client who has an oxygen saturation of 88 Which of the following actions should the nurse take?

Choice A rationale Decreasing the head of the bed or placing the client in a supine position can negatively impact respiratory effort by allowing abdominal organs to push against the diaphragm. This reduces lung expansion and can further lower oxygen saturation from 88 percent. For a client with low oxygen levels, the nurse should instead elevate the head of the bed to a semi-Fowler's or high-Fowler's position. This maximizes thoracic cavity space and improves the efficiency of gas exchange. Choice B rationale Asking the client to cough every 4 hours is an infrequent intervention that may not be sufficient to address an acute oxygen saturation of 88 percent. While coughing helps clear secretions, a four-hour interval is too long for a client currently experiencing significant desaturation. Immediate nursing actions should focus on improving current ventilation and oxygenation. Coughing and deep breathing are more effective when performed more frequently, such as every hour while awake, to prevent atelectasis. Choice C rationale Encouraging the client to take deep breaths is a direct intervention to increase alveolar ventilation and improve gas exchange. Deep breathing expands the lungs, promotes the recruitment of collapsed alveoli, and increases the amount of oxygen reaching the pulmonary capillaries. This can rapidly help raise the oxygen saturation back toward the normal range of 95 to 100 percent. It is a non-invasive, immediate nursing action that empowers the client to improve their own respiratory status. Choice D rationale Requesting a prescription for an opioid analgesic is contraindicated for a client with low oxygen saturation unless the hypoxia is caused by severe pain inhibiting breathing. Opioids are central nervous system depressants that can significantly decrease the respiratory rate and depth of ventilation. Administering an opioid could worsen the client's condition by causing further respiratory depression and lowering the oxygen saturation even more. The priority is to support ventilation and oxygenation, not suppress it.