After a client has a sprained ankle, what should the nurse instruct them to do during the first 24 hours?

Intermittently placing ice on the ankle during the first 24 hours after a sprain is the most appropriate action. This approach aligns with the R.I.C.E. principles, which stand for Rest, Ice, Compression, and Elevation, and are highly effective for managing acute soft tissue injuries such as sprains.

Applying ice helps reduce swelling and numbs the pain by constricting blood vessels, which decreases blood flow to the affected area. By intermittently applying ice—typically for 20 minutes every couple of hours—the client can effectively manage pain and minimize swelling. This method supports the healing process in the initial acute phase of the injury.

Other options, such as only keeping the ankle elevated or applying heat, do not effectively address the immediate management of swelling and pain after a sprain. Additionally, beginning physical therapy right away may not be advisable since it is crucial to allow the initial swelling to decrease. The focus during the first 24 hours should primarily be on minimizing discomfort and preventing further injury.