Final answer:
In assessing left-sided heart failure, a nurse should expect symptoms like cool extremities, dyspnea, and fatigue due to reduced cardiac output and pulmonary congestion. Cool extremities are a result of the body redirecting blood flow to vital organs, leading to less warmth in non-vital areas. Other mentioned symptoms are more indicative of right-sided heart failure.
Step-by-step explanation:
A nurse assessing a client for left-sided heart failure should expect different manifestations compared to right-sided heart failure. Specifically, symptoms of left-sided heart failure are related to the backing up of blood into the lungs, since the left side of the heart is responsible for pumping oxygenated blood into the systemic circulation. Symptoms of left-sided heart failure can include dyspnea (shortness of breath), bibasilar crackles on auscultation of the lungs due to pulmonary congestion, paroxysmal nocturnal dyspnea, elevated pulmonary capillary wedge pressure, restlessness, confusion (due to hypoxia), exertional dyspnea, fatigue, cyanosed skin, and cool extremities.
Cool extremities occur due to the decreased cardiac output that characterizes heart failure; the body prioritizes sending blood to vital organs, thus extremities can become cooler due to reduced blood supply. Other options such as weight gain, enlarged liver, and distended abdomen, are more commonly associated with right-sided heart failure, where the heart cannot pump blood effectively into the systemic circulation, causing systemic venous congestion and peripheral edema.