A nurse is caring for a client who is recovering from a cerebrovascular accident in a rehabilitation facility. The client tells the nurse, "I am sick of being in here, and I want to go home." Which of the following responses should the nurse make?

A) Encourage the client to spend time in the dayroom: While social interaction can be beneficial, a client experiencing mania may become overstimulated in a busy environment. This intervention may not be appropriate if it increases anxiety or agitation.

B) Place the client in seclusion when he exhibits signs of anxiety: Seclusion should be a last resort and is not an appropriate first-line intervention. Instead, the focus should be on therapeutic approaches that promote safety and reduce anxiety without resorting to restrictive measures.

C) Encourage the client to take frequent rest periods: This is a crucial intervention for a client experiencing mania, as it can help manage symptoms and prevent exhaustion. Encouraging rest periods allows the client to regain some control and reduces the risk of overwhelming stimulation.

D) Withdraw the client's TV privileges if he does not attend group therapy: Using punitive measures such as withdrawing privileges is not therapeutic and can exacerbate feelings of rejection or frustration. A supportive approach is more effective in encouraging participation in therapy rather than implementing consequences.

A) Provide the client with a 4g sodium diet: This is incorrect. Clients with acute heart failure typically require a low-sodium diet (often less than 2g per day) to help manage fluid retention and reduce workload on the heart.

B) Ambulate the client every 4 hr while awake: While mobility is important, the frequency and timing of ambulation in clients with acute heart failure should be carefully considered based on their stability and fatigue level. It may not be appropriate to ambulate every 4 hours.

C) Infuse 0.9% sodium chloride 500 mL IV bolus over 1 hr: This is generally not appropriate for clients with acute heart failure due to the risk of fluid overload. Instead, fluid management often involves restricting IV fluids and closely monitoring fluid balance.

D) Administer enalapril 2.5 mg PO twice daily: This prescription is appropriate. Enalapril, an ACE inhibitor, is commonly used to manage heart failure by reducing afterload and improving cardiac output. It helps alleviate symptoms and improve quality of life in heart failure patients.