A client who had a percutaneous coronary intervention (PCI) two weeks ago returns to the clinic for a follow up visit. The client has a postoperative ejection fraction of 30%. Today the client has lungs which are clear, +1 pedal edema, and a 5 pound weight gain. Which intervention should the nurse implement?

A. Instruct the client to monitor daily caloric intake: Nutritional monitoring does not directly address the client’s current signs of early fluid overload. Caloric intake is not the immediate concern given the recent weight gain and decreased ejection fraction. B. Assess compliance with routine prescriptions: With a postoperative ejection fraction of 30%, the client likely has heart failure with reduced ejection fraction (HFrEF). A weight gain of 5 pounds and pedal edema suggest fluid retention, which may indicate suboptimal adherence to prescribed medications such as diuretics. C. Arrange transport for admission to the hospital: Although the client shows signs of mild fluid retention, lung sounds are clear and only +1 edema is noted. Hospital admission is not yet indicated unless symptoms worsen or do not respond to outpatient interventions. D. Insert saline lock for IV diuretic therapy: IV diuretics are used in acute decompensated heart failure, especially when there is pulmonary congestion or volume overload. Since the client has mild edema and clear lungs, oral medication review is the appropriate initial step.