A nurse is preparing a plan of care for a client who is postoperative following a cochlear implant insertion. Which of the following instructions should the nurse include in the plan of care?

A. Restlessness: Restlessness is a common behavioral manifestation in clients with Alzheimer's disease. It can be caused by various factors, including confusion, agitation, discomfort, or unmet needs. Restlessness may manifest as pacing, fidgeting, or difficulty sitting still.

B. Aggression: Aggression, including verbal or physical aggression, is a behavioral manifestation that can occur in clients with Alzheimer's disease. Aggression may result from frustration, confusion, fear, or other underlying factors. It can present challenges for both the individual with Alzheimer's and their caregivers.

C. Depression: Depression is a mood disorder that can occur in individuals with Alzheimer's disease. Symptoms of depression may include persistent sadness, feelings of hopelessness, social withdrawal, and loss of interest in previously enjoyed activities. Depression can exacerbate cognitive decline and functional impairment in individuals with Alzheimer's.

D. Hyperactivity: Hyperactivity, characterized by excessive or restless activity, can occur in some individuals with Alzheimer's disease. Hyperactivity may be a manifestation of agitation, anxiety, or other underlying factors. It can present challenges for caregivers and may require interventions to manage.

E. Lethargy: Lethargy, or extreme fatigue and lack of energy, can also occur in individuals with Alzheimer's disease. Lethargy may result from physical and cognitive decline, medication side effects, depression, or other medical conditions. It can contribute to decreased engagement in activities and worsening of cognitive function.

A. Decrease sedation: Decreasing sedation may help reduce intracranial pressure (ICP) by allowing the client to have a more responsive level of consciousness. However, it is not a direct treatment for brain herniation. Sedation reduction should be done cautiously to prevent agitation and further increases in ICP.

B. Hyperventilate the client: Hyperventilation is a temporary intervention used to reduce intracranial pressure by inducing cerebral vasoconstriction, which decreases cerebral blood flow and intracranial volume. However, it is typically reserved for acute situations and is not considered a definitive treatment for brain herniation. Prolonged or excessive hyperventilation can lead to cerebral ischemia and should be used cautiously.

C. Lower blood pressure: Lowering blood pressure may help reduce cerebral perfusion pressure, which can mitigate the risk of further brain injury during herniation. However, lowering blood pressure alone is not a direct treatment for brain herniation. It may be part of the overall management strategy to prevent secondary injury.

D. Reduce the temperature in the room: Reducing the temperature in the room, or therapeutic hypothermia, is sometimes used in the management of elevated intracranial pressure and brain injury. Lowering body temperature can reduce metabolic demands and cerebral edema, thereby lowering intracranial pressure. However, it is not a direct treatment for brain herniation and should be implemented cautiously to prevent complications such as shivering and hypotension.