Which discharge instruction is appropriate for a client with heart failure?

• A. Exercise at least 3 times per week
• B. Take diuretics early in the morning and before bedtime
• C. Notify the provider of a weight gain of 0.5 kg (1 lb) in a week
• D. Take naproxen for discomfort

Answer: (A)

Regular, moderate aerobic activity several days a week is beneficial for heart failure because it improves endurance, strengthens skeletal muscles, and can help reduce symptoms and hospital readmissions. Exercising at least three times per week, within the patient’s tolerance and after medical clearance, supports better daily functioning and overall heart health. Start gently, choose low-impact activities like walking, and increase gradually while watching for warning signs such as unusual shortness of breath, chest pain, or dizziness.

Taking diuretics both early in the morning and before bedtime would lead to nighttime urination and sleep disruption, so bedtime dosing is generally avoided; diuretics are typically taken in the morning to manage fluid while preserving sleep. Notifying a provider about a weight gain of only about 1 pound in a week is usually not urgent, since guidelines tend to emphasize reporting larger gains (such as several pounds in a week) that suggest fluid retention. Finally, naproxen is an NSAID that can cause fluid retention and worsen heart failure, so it’s not appropriate for someone with this condition; safer pain relief options like acetaminophen are preferred.