Objective — observe

• General appearance: distress, color, diaphoresis, and work of breathing.
• Peripheral edema distribution (ankle, pretibial, sacral), pitting grade, and symmetry.
• Jugular venous distension at 30–45°; visible heave or lift; displaced point of maximal impulse.
• Skin color and temperature, cyanosis, mottling, and capillary refill.
• Device and self-monitoring: home BP cuff use and technique, the weight log, and a pulse oximeter if used.