Select the best answer: A primary care nurse practitioner is…
Select the best answer: A primary care nurse practitioner is performing a follow-up visit with a 68-year-old Caucasian adult diagnosed with NYHA Class III heart failure with reduced ejection fraction. The patient is currently prescribed sacubitril/valsartan 49mg/51mg (Entresto) daily and carvedilol (Coreg) 12.5 mg daily. The patient reports increased edema to the point that it is difficult to put on shoes. On physical exam, the NP notes jugular venous distention, a 3rd heart sound with a displaced PMI, and hepatomegaly. A renal profile, including a full electrolyte panel, and CBC are unremarkable. A BNP of 658 pg/mL is reported. What additional action can the nurse practitioner can take to optimize this patient’s treatment plan?