Which assessment finding may indicate heart failure exacerbation?

The presence of peripheral edema and dyspnea on exertion is significant in assessing heart failure exacerbation. Heart failure often leads to fluid retention due to the heart's decreased ability to pump effectively, resulting in swelling in the lower extremities or other parts of the body. This edema occurs because the kidneys retain sodium and water in response to perceived low blood volume, which is often a compensatory mechanism of the body.

Dyspnea on exertion indicates that the body is struggling to deliver adequate oxygen during increased physical activity, which can happen when fluid accumulates in the lungs, also known as pulmonary congestion. This combination of signs is commonly seen in conditions with worsening heart function, particularly in patients with chronic heart failure, making it a critical assessment finding for exacerbation.

In contrast, other options include findings that may not specifically relate to heart failure exacerbation. Coolness of extremities with increased urination could indicate issues such as shock or peripheral vascular disease. Elevated temperature and headache might suggest an infection or inflammatory process, while increased appetite and energy levels generally do not align with the typical presentation of heart failure exacerbation, where symptoms would more likely point to fluid overload and decreased functional capacity.