Identify several factors in the environment that can affect physical fitness levels.

High altitude climate

terrain humid there you go I hope I helped a lil

Begin the patient on aspirin 81 mg and clopidogrel 75 mg daily.

Explanation:

With regards to the information given, the appropriate next step is to begin the patient on aspirin 81 mg and clopidogrel 75 mg daily.

The patient has a disease that's called the peripheral arterial disease. This is a disease that's caused by atherosclerosis which is when fatty deposits are built on the artery walls which then lead to the reduction in the blood flow. This can be treated by the use of antiplatelet agents, such as aspirin or clopidogrel.

Therefore, the most appropriate next step is to "Begin the patient on aspirin 81 mg and clopidogrel 75 mg daily".