An older adult client with a history of heart failure (HF) is brought to the clinic by a family member. Which finding(s) confirm(s) to the nurse that the client is experiencing an exacerbation of the HF? Select all that apply.

Choice A reason: Dyspnea is a hallmark sign of heart failure exacerbation due to pulmonary congestion and reduced cardiac output. It often worsens with exertion or when lying flat. Choice B reason: Intercostal retractions are typically associated with respiratory distress in pediatric populations or severe pulmonary conditions, not commonly with HF exacerbation in adults. Choice C reason: Headaches are nonspecific and not a reliable indicator of heart failure exacerbation. They may be related to other conditions such as hypertension or medication side effects. Choice D reason: Peripheral edema occurs due to fluid retention and increased venous pressure, especially in right-sided heart failure or advanced stages of HF. Choice E reason: Jugular venous distension reflects elevated central venous pressure and is a classic sign of right-sided heart failure or fluid overload.