A nurse is caring for a client who is at 32 weeks of gestation and has a history of cardiac disease. In which of the following positions should the nurse place the client to promote optimal cardiac output?

A. High Fowler's: High Fowler’s position can assist with respiratory effort and comfort, but it does not specifically optimize cardiac output in a pregnant client. Upright positioning alone may not relieve pressure from the gravid uterus on major vessels. B. Left lateral: Placing the client in the left lateral position relieves pressure of the uterus on the inferior vena cava and aorta, enhancing venous return to the heart and improving cardiac output. This position is especially important in clients with cardiac disease to reduce the risk of supine hypotensive syndrome and optimize maternal and fetal circulation. C. Standing: Standing does not provide support for venous return and can increase the workload on the heart, potentially exacerbating cardiac compromise. It is not recommended for prolonged periods in clients with cardiac disease during pregnancy. D. Supine: Supine positioning can compress the inferior vena cava and aorta, reducing venous return and cardiac output. This can lead to hypotension and decreased perfusion to both the mother and fetus, making it unsafe for pregnant clients with cardiac disease.