What Is the Most Appropriate Nursing Action to Take First Based on the Patient’s Symptoms

a 65-year-old Male Patient Was Admitted to the Hospital with Complaints of Shortness of Breath, Fatigue and Swollen Ankles. the Patient Has a History of Hypertension and Type 2 Diabetes Mellitus. during the Nursing Assessment, the Nurse Observed Jugular Vein Distension and Auscultated Crackles at the Lung Bases