Nancy is a 78 yo Caucasian female with a past medical histor…
Nancy is a 78 yo Caucasian female with a past medical history of heart failure (Class I, Stage B), hypertension and diabetes who arrives for a regular follow-up visit. She monitors her weight daily and has kept her weight consistent for several weeks. She avoids salt and is very careful with her fluid intake. She swims for 20-30 minutes each day. Her current medications include: Candesartan (Atacand*) 32mg daily Metoprolol succinate XL (Toprol XL) 100mg twice daily Furosemide (Lasix*) 40mg twice daily K-dur (potassium supplement) 20mEq once daily Insulin glargine (Lantus*) 35 units at bedtime Insulin aspart (Novolog*) 10 units with meals. Her physical exam shows no JVD, clear lung sounds, and minimal edema of her feet. Her labs and vitals include Na 139 , K 2.9 , Cl 109 , Mg 2.0 , BUN 14 , Cr 1.2 [