A nurse in an emergency department is caring for a client. For each assessment finding, click to specify if the client finding is consistent with heart failure or pericardial effusion. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.

Rationale: • Lower extremities: Peripheral edema results from fluid overload and increased venous pressure commonly seen in heart failure. Impaired ventricular function causes blood to back up into the systemic circulation, leading to dependent edema. Pericardial effusion may cause systemic congestion if tamponade develops, but isolated 1+ edema is more characteristic of heart failure exacerbation. • Respiratory finding: Shortness of breath and orthopnea occur in heart failure due to pulmonary congestion from left ventricular dysfunction. Pericardial effusion can also cause dyspnea because accumulated fluid compresses the heart, reducing cardiac output and leading to pulmonary venous pressure changes. Both conditions can impair effective oxygen delivery and cause respiratory distress. • Cough: A productive cough with pink-tinged sputum is strongly associated with pulmonary edema from left-sided heart failure. Fluid leaks into the alveoli, creating frothy or blood-tinged secretions. Pericardial effusion typically does not produce pulmonary fluid accumulation or pink sputum unless severe secondary heart failure develops. • Heart rate: Tachycardia is a compensatory mechanism in both conditions to maintain cardiac output. In heart failure, reduced stroke volume stimulates sympathetic activation. In pericardial effusion, especially with tamponade physiology, the heart rate increases to compensate for restricted ventricular filling and decreased output.