The nurse in the long-term care facility is caring for an 81-year-old female client.
| Day 1 0700 | Day 2 0700 | Day 3 0700 | Day 4 0700 | |
|---|---|---|---|---|
| Weight (same scale, before breakfast) | 80.0 kg (176.0 lb) | 80.3 kg (176.7 lb) | 81.0 kg (178.2 lb) | 82.6 kg (181.7 lb) |
| Lung sounds | clear | clear | clear | fine crackles in both bases |
| Ankle edema | trace | trace | 1+ | 2+ |
| Pillows to sleep | 1 | 1 | 2 | 3 |
| Pulse oximetry reading (room air) | 97% | 97% | 96% | 96% |
Which action should the nurse take first in response to these findings?