Evaluate jugular venous pressure by watching for distention of the jugular vein. It is normal for the jugular veins to be visible when the client is supine. To evaluate jugular vein distention, position the client in a supine position with the head of the bed elevated 30, 45, 60, and 90 degrees. The jugular vein should not be distended, bulging, or protruding at 45 degrees or greater. This jugular venous pressure is an indirect reflection of the: