Scenario: An 82-year-old woman with a history of chronic heart failure is in the Emergency Department with increased dys

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Scenario: An 82-year-old woman with a history
of chronic heart failure is in the Emergency Department with
increased dyspnea, extreme fatigue, and a non-productive cough. She
states that she can hardly walk to the bathroom from her bedroom
without having to stop to rest. Her lower legs are swollen with 3+
edema, and she states that she has gained about 8 pounds over the
past few days. When questioned about her medications, she states,
“I have been skipping my fluid pill because I hate having to go to
the bathroom so much. I get so short of breath.”
Vital signs: Temperature 99.9°F (37.7°C), Pulse 110/bpm and
regular, Respirations 28/min, Blood Pressure 188/98 mm Hg.
She is admitted to the telemetry unit with a diagnosis of
exacerbation of heart failure, and given prophylactic anticoagulant
therapy, aggressive diuretic therapy, as well as an ACE inhibitor.
After a week, the nurse documents the following assessment
findings.