In which stage of heart failure do clients experience symptoms at rest?

Clients in Class IV heart failure experience symptoms even at rest, which signifies the most severe form of heart failure. In this stage, patients may struggle with basic activities and often have significant fatigue, shortness of breath, and other distressing symptoms even when they are not exerting themselves. This classification indicates a high level of impairment in daily functioning and substantial limitations in physical activity.

In contrast, the other classes reflect less severe stages of heart failure. Class I patients typically have no limitations and are asymptomatic, while Class II patients experience symptoms with more than ordinary exertion. Class III patients have marked limitations in activity but can be comfortable at rest, experiencing symptoms during less vigorous activities. Hence, the distinction of Class IV indicates the critical nature of the condition that results in symptoms regardless of activity level.