Josina is a 65 yo AA woman who presents to clinic feeling ti…
Josina is a 65 yo AA woman who presents to clinic feeling tired for the last 3 months. She is able to complete some light housework and cook her dinners, but she has difficulty breathing when doing more activity such as grocery shopping and walking up stairs. She sleeps on 2 pillows at night to help with her breathing. PMH: Heart failure with reduced ejection fraction (class III, stage C) HTN, arthritis. Physical exam: Edema of her feet and ankles (2+) with some crackles noted in the lungs on inspiration Medications: HCTZ (Hydrodiuril*) 12.5mg daily, and ibuprofen (Motrin* / Advil*) 200mg BID for arthritis in knee. Vitals: height 5’2″, 63kg, BP 134/84, HR 78, EF 35% per echocardiogram. Which of the following is most appropriate regarding diuretic therapy for Josina?