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so which signs and symptoms will help a provider distinguish between congestive heart failure and chronic obstruction pulmonary disease would it be a cyanosis b wheezing c dyspnea or d dependent edema now how many of you guys picked be wheezing i know so many people think copd has to be associated with wheezing and or restricted flow so itamp;#39;s going to be diminished and they also think chf has to be crackles or rails now with our chf patients depending on where that fluid accumulates inside the bronchioles it can actually restrict flow and sound like a wheeze and we call this a cardiac wheeze now pay a close attention to that patientamp;#39;s assessment we need to know hey do they have history of asthma do they have history of copd if they say no you must think that this could potentially be cardiac so pay attention to their their past medical history look at their meds if they are on cardiac meds and their blood pressure is high we need to really sit down and think that
