A nurse is auscultating a client's heart sounds and hears a third heart sound (S3). Which finding is consistent with the presence of an S3 sound in a client with congestive heart failure?

A) This choice is incorrect because orthopnea is a different symptom where the client experiences difficulty breathing while lying flat and finds relief by sitting upright or standing.

B) This choice is correct. Paroxysmal nocturnal dyspnea is characterized by sudden breathlessness that awakens the client from sleep, usually 1-2 hours after falling asleep. The client may feel the need to sit upright or dangle the legs to breathe comfortably.

C) This choice is incorrect because peripheral edema refers to swelling in the legs, ankles, and feet, which is a common symptom of congestive heart failure but does not match the client's reported symptom.

D) This choice is incorrect because tachypnea is rapid breathing and is not specifically related to the client's nighttime symptom of sudden breathlessness.

A) This choice is incorrect because limiting fluid intake to 1 liter per day is too restrictive and may lead to dehydration. Fluid restriction is essential for some clients with CHF, but the specific limit should be determined by the healthcare provider based on the client's individual needs.

B) This choice is incorrect because fluid restriction should not be limited to the evening only. Clients with CHF should monitor their fluid intake throughout the day to prevent fluid overload.

C) This choice is incorrect because drinking fluids primarily with meals may not be sufficient for managing fluid intake. Fluid intake should be balanced throughout the day to avoid excessive fluid retention.

D) This choice is correct. Monitoring daily weights is an essential strategy for clients with congestive heart failure to manage fluid balance. Sudden weight gain can indicate fluid retention, a common symptom of CHF. Clients should be instructed to report any significant weight changes to their healthcare provider promptly.