Your Patient Is a 68-Year-Old Female Who Is Conscious but Confused

Multiple Choice

Your patient is a 68-year-old female who is conscious but confused and lying supine in bed without complaint. Her daughter states that the patient was recently diagnosed with a bladder infection and has been taking antibiotics. She also states that her mother has not produced urine for two days, during which she has become increasingly confused. Physical examination reveals swelling to the face, hands, and feet; cool and moist skin; and lung sounds that are clear and equal bilaterally. HR = 104, BP = 142/88, RR = 14, SaO₂ = 96%. In addition to administering oxygen and monitoring the cardiac rhythm, which of the following courses of action is most appropriate?

A) IV of NS with 250 cc fluid challenge
B) 12-lead ECG, IV of NS KVO
C) IV of NS KVO, furosemide, 40 mg
D) IV of NS KVO