Jane
b. reath is a 67 year old female with a history of congestive heart failure. mrs. reath is an ex-smoker and only recently has decided to commit to a healthier lifestyle. since her decision, she is conscientious about her diet and exercise and her ultimate goal is to discontinue taking her cardiac medications which include digoxin and lasix; she believes that if she can maintain this healthy lifestyle her body will no longer require therapeutic intervention. recently though, mrs. reath has been noticing an increase in shortness of breath when engaging in simple tasks and also has noticed some "heart skipping." because of this, she decides to visit her doctor. assume you are mrs. reath's doctor. here are your physical assessments and findings: her chest x-ray shows pleural effusion in the right lower lobe. her labs reveal normal na , k and bun, and creatinine levels. she is alert and oriented, exhibiting crackles in the lungs bilaterally. bowel movement is normal and her urine is clear and unremarkable. she exhibits a normal heart rate and temperature, but has a blood pressure of 156/94 and her weight has increased 15lbs since her last visit one month ago.