Howard, age 58, presents to the emergency department with a variety of signs and symptoms. Howard has a history of cardiac diffi
culties, including a myocardial infarction 5 years ago. Since that time, Howard has continued to struggle with lifestyle modifications, such as diet and exercise, to reduce his risk of future cardiac events. As the first clinician to see Howard, you record the following signs and symptoms:
headache and memory loss; cyanosis; heart rate of 100 bpm; BP of 100/70 mm Hg; ascites; orthopnea; paroxysmal nocturnal dyspnea; pulmonary crackles and edema; peripheral pitting edema; and cool, pale extremities.
Which of his signs and symptoms are associated with right-side heart failure? Select all that apply.
A) Ascites
B) Headache and memory loss
C) Cyanosis
D) Peripheral pitting edema
E) Cool, pale extremities
Physical environment refers to the inanimate things like air, water, soil, rock, etc. the biological environment is all living things big and small, plant or animal, and microbes etc.
