A 73-Year-Old Woman with Congestive Heart Failure Is Being Prepared

A 73-year-old woman with congestive heart failure is being prepared for discharge from the hospital.  The patient has heart failure with reduced ejection fraction and has been admitted to the hospital twice in the past 60 days.  Medical history is notable for ischemic heart disease, chronic obstructive pulmonary disease, and hypertension.  Vital signs are normal.  Pulmonary examination shows normal respiratory effort and no crackles, and there is no peripheral edema.  The patient asks to stay in the hospital for a few additional days and says, "I feel fine right now, but I am worried that if I go home, I might end up back in the hospital again."  Which of the following is the most appropriate response to this patient's request?

A) "Managing heart failure at home can be difficult.  What family members are nearby who can help?"
B) "Since you are worried about going home, would you like to go to a nursing home until you feel more confident?"
C) "Some people with heart failure have problems due to too much salt intake.  Can you tell me about your diet?"
D) "What do you think are some reasons why your heart failure might be worse at home?"
E) "Your condition has now stabilized.  What benefit are you hoping to gain from a continued stay?"

Correct Answer:

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