A nurse is caring for a client who has a spinal cord injury and is at risk for depression. Which of the following findings should the nurse identify as an indication that the client is developing depression?

Choice A reason: The statement "Your heart stops" is incorrect; heart failure does not mean the heart has stopped functioning.

Choice B reason: "Your heart is pumping too much blood" is not accurate; heart failure often means the heart cannot pump enough blood to meet the body's needs.

Choice C reason: While an area of heart muscle may die during a heart attack, this is not the defining characteristic of heart failure.

Choice D reason: The most accurate description of heart failure is that the heart is not pumping efficiently, which can lead to symptoms like fatigue and shortness of breath.

Choice A reason: Encouraging the client to sleep during the day can disrupt the normal sleep-wake cycle and is not recommended for managing insomnia associated with depression.

Choice B reason: Scheduling a brisk physical activity before bedtime can be stimulating and may actually make it more difficult for the client to fall asleep.

Choice C reason: Monitoring for bouts of diarrhea is not directly related to the care of a client with severe depression unless the client is on specific medications that may cause gastrointestinal upset as a side effect.

Choice D reason: Offering frequent small snacks can help manage the weight loss and decreased appetite often seen in clients with severe depression, ensuring they receive adequate nutrition.