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REQUIRED for HF Accreditation: NYHA/symptoms with activity performed?
Indicate whether documented NYHA classification
has been completed or documented symptoms with activity, this can be documented by nursing staff or physician.
Class I: patients with cardiac disease but without resulting limitations of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, or dyspnea.
Class II: patients with cardiac disease resulting in slight limitation of physical activity. They are comfortable at rest. Ordinary physical activity results in fatigue, palpitation, or dyspnea.
Class III: patients with cardiac disease resulting in marked limitation of physical activity. They are comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea.
Class IV: patients with cardiac disease resulting in inability to carry on any physical activity without discomfort. Symptoms are present even at rest or minimal exertion.

“The regulators were pretty skeptical at the start, I have to say,” Stephen Eimer, an executive vice president with Related tells Mercury News . After much back and forth, Bay Area regulators have finally accepted Related’s technical document that outlines how the site would be made safe. A foot-thick concrete barrier would be laid over 30 square acres. Housing would be built over shops and restaurants to create more distance between the residents and the waste. Sensors and alarm systems would monitor gasses and a separate system would collect and dispose of it.  

Unneeded medications should be disposed of in special ways to ensure that pets, children, and other people cannot consume them. However, you should not flush this medication down the toilet. Instead, the best way to dispose of your medication is through a medicine take-back program. Talk to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in your community. See the FDA's Safe Disposal of Medicines website ( http:///c4Rm4p ) for more information if you do not have access to a take-back program.

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