Which assessment finding is most indicative of congestive heart failure?

Peripheral edema is a key indicator of congestive heart failure (CHF) because it results from the body's response to fluid overload. In CHF, the heart's ability to pump blood effectively is compromised, leading to increased pressures in the heart and blood vessels. This elevated pressure causes fluid to leak from the blood vessels into the surrounding tissues, primarily in the lower extremities, presenting as swelling or edema.

While hypertension, elevated blood glucose, and increased respiratory rate can be associated with various cardiovascular and metabolic conditions, they are not as specific for CHF as peripheral edema. Hypertension may occur in many patients but is not exclusively indicative of heart failure. Elevated blood glucose levels can be seen in diabetes or stress-related states, and while an increased respiratory rate can be a response to many conditions, it is not unique to CHF. Therefore, the presence of peripheral edema is the most telling sign of congestive heart failure.