What assessment finding suggests the presence of pulmonary oedema rather than a chest infection?

The presence of high blood pressure and shortness of breath is indicative of pulmonary oedema, which can occur when fluid accumulates in the lungs due to heart failure or other conditions affecting the heart's ability to pump effectively. In cases of pulmonary oedema, the heart's compromised function leads to increased pressure in the pulmonary circulation, resulting in fluid leakage into the alveoli and causing shortness of breath. This scenario aligns well with the clinical picture of pulmonary oedema, making the presence of high blood pressure and shortness of breath a significant assessment finding.

In contrast, a productive cough with elevated temperature, unilateral crackles accompanied by peripheral edema, or fever with central tight chest pain would suggest other conditions, such as infections or localized issues within the lungs. These findings might signal pneumonia or other respiratory infections, but the combination of high blood pressure and shortness of breath points more directly to pulmonary involvement due to fluid accumulation rather than an infectious process.