A client presents with new-onset heart failure. Which finding(s) should the nurse recognize as manifestations of left-sided heart failure? (Select all that apply)

Choice A reason: Left-sided heart failure causes blood to back up into the pulmonary circulation. This increase in hydrostatic pressure forces fluid into the alveoli. When this fluid mixes with air, it results in a pink, frothy sputum, which is a classic clinical indicator of acute pulmonary edema. Choice B reason: Jugular vein distention (JVD) is a hallmark sign of right-sided heart failure. It occurs when the right ventricle cannot effectively pump blood into the pulmonary artery, causing a backup into the superior vena cava and the systemic venous system, manifesting as visible neck vein swelling. Choice C reason: Shortness of breath when lying flat, or orthopnea, occurs in left-sided failure because fluid in the lungs redistributes when the patient is recumbent. This increases pulmonary congestion and decreases gas exchange, forcing the patient to use multiple pillows or sit upright to breathe comfortably. Choice D reason: Fatigue is a generalized symptom that can occur in both types of heart failure due to decreased cardiac output. While common, it is less specific for the "left-sided" designation than the pulmonary symptoms like orthopnea and frothy sputum which result directly from left ventricular dysfunction. Choice E reason: Dependent peripheral edema, such as swelling in the ankles and feet, is a result of systemic venous congestion. This occurs when the right side of the heart fails to pump efficiently, leading to fluid accumulation in the tissues of the lower extremities due to gravity.