Histоry аnd Physicаl: Histоry аnd Physical: Past medical histоry for atrial fibrillation, hypertension, alcohol abuse, and hypothyroidism. Denies illicit drug use. Smokes one pack of cigarettes per day. Recent admission two weeks prior for atrial fibrillation with rapid ventricular rate (RVR) and was found to have severe left ventricular (LV) dysfunction with an ejection fraction (EF) of 20-25%. The client presented to the ED with bilateral lower leg swelling and complaints of shortness of breath (SOB) for the past two weeks. He reports orthopnea and worsening SOB with any activity. He also reports that over the last few days he has noticed that his leg swelling has worsened. Nurses Note: 1/20/23 at 1940: Client arrived in the ED via EMS. Alert and oriented x 3. Client placed on telemetry monitor, showing atrial fibrillation with RVR. Vital signs: 97.1*F, P 164, RR 26, BP 150/102, SpO2 94% on room air. Lung sounds with crackles in bilateral bases. Breathing is labored at times. Jugular venous distention (JVD) is observed. Skin is cool to touch and diaphoretic. Capillary refill