The nurse is assessing a client with right-sided heart failure. Which of the following findings should the nurse expect? Select all that apply.

A. Limiting physical activity: Sedentary behavior is a risk factor for hypertension and cardiovascular disease. Regular aerobic exercise helps lower blood pressure by improving vascular compliance and reducing systemic resistance. Clients should be encouraged to increase, rather than limit, their level of moderate physical activity.

B. Giving up smoking cigarettes: Nicotine causes immediate vasoconstriction and increases heart rate, leading to acute elevations in blood pressure. Long-term smoking damages the arterial walls and accelerates the development of atherosclerosis. Cessation is one of the most effective lifestyle changes for improving overall vascular health and reducing pressure.

C. Eating canned vegetables daily: Canned foods are typically very high in sodium, which is used as a preservative. High sodium intake leads to water retention and increased blood volume, which raises blood pressure. Clients should be advised to choose fresh or frozen vegetables to minimize their sodium consumption.

D. Pursuing measures for losing weight: Excess body weight increases the workload on the heart and is closely linked to metabolic changes that raise blood pressure. Even a modest reduction in weight can lead to a significant decrease in systolic and diastolic readings. Weight management is a cornerstone of non-pharmacological hypertension treatment.

E. Reducing sodium in the diet: High dietary salt intake triggers the body to retain fluid, increasing the total volume within the vascular system. Reducing sodium intake to less than 2,300 mg per day helps lower blood pressure and reduces the risk of stroke. This change directly addresses the fluid-volume component of hypertension.

A. Obtain manual blood pressure: Assessing the hemodynamic status is the priority when a client reports a racing heartbeat and shortness of breath. An irregular rhythm following conversion of atrial fibrillation requires immediate validation of perfusion and blood pressure stability. Manual measurement provides the most accurate clinical data for determining the severity of the cardiovascular change.

B. Measure airflow via incentive spirometry: Incentive spirometry is used to prevent atelectasis and is not a diagnostic tool for acute shortness of breath or cardiac arrhythmias. It does not provide information regarding the underlying cause of the "racing heartbeat" or the irregular rhythm. Priority must be placed on cardiovascular assessment rather than routine respiratory exercises.

C. Insert indwelling urinary catheter: There is no immediate clinical indication for an invasive urinary catheter based on the client's current symptoms of palpitations and dyspnea. While monitoring output is important in heart failure, it is secondary to stabilizing the client's heart rate and rhythm. Catheterization poses an unnecessary infection risk in this acute assessment phase.

D. Assist the patient to get dressed to work with physical therapy: Engaging in physical exertion while experiencing tachycardia and shortness of breath is dangerous and contraindicated. The client's reports of a "racing heartbeat" and irregular rhythm indicate a potential relapse into atrial fibrillation with rapid response. Physical activity should be deferred until the client is hemodynamically stable.