113. A 64-year-old man is admitted to the ICU with worsenin…
113. A 64-year-old man is admitted to the ICU with worsening SOB over the past 4 days. His vital signs are: temp 100.5 °F, HR 124, RR 34, BP 80/62 mm Hg; and SPO2, 85% on room air. His urine output has declined from 600 mL/day to 100 mL/day despite no change in fluid intake. His peripheral extremities are cold and clammy. The family says that he has become more confused over the past week. His serum electrolyte levels are: sodium, 136 mEq/L; potassium, 5.3 mEq/L; chloride, 101 mEq/L; BUN, 74 mg/dL; and creatinine, 4.6 mg/dL. His CVP 28 mm Hg. You obtain a chest x-ray (pictured). After administering oxygen, which of the following is the most appropriate next step to resolve his symptoms?
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