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Etiology Smoking Assessment Fatigue, dyspnea, increase BP, cyanosis, cold clammy skin, orthopnea, arrhythmia, jugular vein distention, oliguria, anuria, decrease PR, rales, restlessness, syncope, vertigo, weakness, DOB, delayed capillary refill, nausea, and vomiting, loss of consciousness, memory loss Nursing Diagnosis Decreased cardiac output related to decrease venous return

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She highlighted the need for local-level research that produced appropriate evidence for local policy and decision-makers adding that this was a key element in Botswanas success