While conducting a history, the patient described interrupted sleep patterns because of frequent urination and episodes of dyspnea. These symptoms are most likely related to which of the following systems?
1. cardiovascular
2. respiratory
3. neurologic
4. renal
1
Rationale: Although any of the above systems may elicit one of the symptoms, the most likely cause is the cardiovascular system. The patient is describing episodes of paroxysmal nocturnal dyspnea, which is related to left ventricular failure. The prolonged supine position allows dependent fluid from the lower extremities to recirculate causing volume overload, dyspnea, and increased urinary excretion.
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