To ensure adequate cardiac emptying during labor, a client with class II heart disease should be encouraged to:

Encouraging a client with class II heart disease to remain in a side-lying position with the head elevated is essential for several reasons related to cardiac function during labor. This position helps to optimize venous return to the heart, which can facilitate adequate cardiac emptying.

In a side-lying position, especially the left side, there is reduced pressure on the inferior vena cava, a major vein carrying blood back to the heart. This helps enhance circulation and prevent supine hypotensive syndrome, which can occur when a pregnant individual lies flat on their back and weight compresses the major blood vessels. Additionally, having the head elevated can support better respiratory function and decrease the work of breathing, important in cases of compromised heart function.

While local anesthesia might provide pain relief during vaginal birth, it doesn’t directly address the cardiac output or venous return concerns that arise during labor for someone with heart disease. Avoiding analgesics may lead to increased pain and stress, which can further burden the heart, and breathing slowly after each contraction, while beneficial for relaxation, does not specifically enhance cardiac emptying in the same way that positioning does. Thus, the side-lying position is pivotal in supporting cardiac function during labor for patients with heart disease.