Q. A 57-year-old female was admitted 3 days ago for a hypertensive emergency. She underwent cardiac catheterization on the day of admission and is preparing to be discharged home today. The patient was discontinued off all intravenous (IV) medications yesterday and transitioned to oral medications. In addition to sertraline 100 mg by mouth (PO) once daily and famotidine 20 mg PO once daily (her only previous home medications), she was started today on enoxaparin 40 mg subcutaneous (SQ) once daily, lisinopril 40 mg PO once daily, and diltiazem 180 mg PO once daily. You are called by her nurse because over the past hour the patient has complained of swelling in her hands and feet, and the sensation of a “lump in her throat”. Upon arrival at the bedside, you find the patient sitting comfortably in bed and in no acute distress, though she speaks with a hoarseness and roughness not previously noted. On physical examination, her blood pressure is 120/60 mm Hg, heart rate 70/min, and respiratory rate 15/min. Based on what you know at this point, what is the most appropriate next step in managing this patient?

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