In left-sided heart failure, what symptom is expected in a client when lying flat?

In left-sided heart failure, the expected symptom when a client is lying flat is orthopnea. This condition occurs when fluid accumulates in the lungs due to gravitational forces being altered when the individual changes position from sitting or standing to lying down. In the supine position, the blood flow returning to the heart increases, leading to pulmonary congestion and difficulty breathing. Patients often report shortness of breath or an increased need for pillows to prop themselves up while sleeping, which is characteristic of orthopnea.

Other symptoms such as ascites, hepatomegaly, and fluid retention are more commonly associated with right-sided heart failure or systemic congestion. Therefore, framing orthopnea as the symptom that specifically relates to the positional change in left-sided heart failure highlights its significance in assessing heart function and managing patient care effectively.