A nurse is assessing a client who has heart failure. Which of the following client statements should indicate to the nurse that the client needs a referral for cardiac rehabilitation?

A. "I need to start eating a low-sodium diet." is incorrect because this statement reflects understanding of a standard self-care recommendation for heart failure. The client is aware of dietary modifications to manage fluid retention. B. "I will weigh myself daily." is incorrect because daily weight monitoring is an appropriate self-care behavior in heart failure to detect fluid retention early. This indicates good self-management, not a need for referral. C. "I'm too tired to brush my teeth." is correct. Fatigue that interferes with basic activities of daily living indicates functional limitations and reduced exercise tolerance. This is a key indicator that the client may benefit from cardiac rehabilitation, which provides supervised exercise, education, and support to improve cardiovascular function, strength, and quality of life. D. "I hate how I feel all the time." is incorrect for immediate referral to cardiac rehab. While this statement reflects emotional distress, it does not specifically indicate functional limitations requiring cardiac rehabilitation. Referral to counseling or support groups may be appropriate instead.