A 72-year-old client with a history of heart failure is admitted for acute decompensation. Assessment findings include a weight gain of 4 kg over 3 days, bilateral pitting edema to the knees, crackles in both lung bases, and a blood pressure of 158/94 mmHg. The client states, 'I've been drinking a lot of water because I thought that would help flush out the extra fluid.' Which nursing intervention is the most appropriate initial action?
- Implement fluid restriction as prescribed and educate the client that excess fluid intake worsens fluid overload.
- Place the client in the Trendelenburg position to improve venous return to the heart.
- Administer a 500 mL normal saline bolus to increase renal perfusion and promote diuresis.
- Encourage continued oral fluid intake to promote urinary output and natural diuresis.