What is the mechanism of the most likely cause of extracellular volume excess in this patient?

• Decreased cardiac inotropy

• Increased antidiuretic hormone secretion

• Increased capillary permeability

• Decreased oncotic pressure

What Is The Next Best Step In Management?

• Discontinue valsartan.

• Initiate ultrafiltration.

• Prescribe furosemide intravenously.

• Initiate dobutamine.

What is the most likely side effect of this therapy?

• Worsening hypertension

• Heart failure

• Nausea

• Lower extremity edema

What product should be administered at this time?

• One unit of packed red blood cells

• 500 mL of 5% albumin

• 1 L of 0.9% saline

• 1 L of isotonic sodium bicarbonate

What is the most likely finding on further workup?

• Pulmonary hypertension

• Splenomegaly

• Acquired thrombotic disorder

• Malignancy