Soru

A $34$-year-old primigravida at $37$ weeks gestation is evaluated in the obstetric triage unit for worsening difficulty breathing over the past week. She states that she becomes excessively winded when walking up a single flight of stairs and has recently started using three pillows to sleep comfortably at night. She has a past medical history of mild persistent asthma, for which she occasionally uses an inhaled corticosteroid. Vital signs show a temperature of $37.0^\circ\text{C}$ ($98.6^\circ\text{F}$), blood pressure of $118/78\text{ mmHg}$, pulse of $110/\text{min}$, and respiratory rate of $22/\text{min}$. Pulse oximetry is $94\%$ on room air. Physical examination reveals prominent distension of the neck veins while sitting at a $45$-degree incline. Chest auscultation reveals fine crackles at the bilateral lung bases. Cardiac auscultation reveals a regular tachycardia and an extra, low-pitched sound in early diastole. There is $2+$ pitting edema extending to the mid-shins bilaterally. Which of the following is the most appropriate next step in patient care?