A 68-year-old presents with increasing shortness of breath,…

A 68-year-old presents with increasing shortness of breath, fatigue, and swelling in his lower extremities over the past two weeks. On physical exam, he has bilateral pitting edema in his ankles, crackles at the lung bases, and an S3 heart sound is auscultated at the apex during early diastole. Vital signs are: BP 171/89 mmHg, Pulse 96 bpm, RR 26, SpO₂ 93% on room air. Which of the following disorder should the AGACNP be concerned for? 

A 69 year old presents with shortness of breath and subject…

A 69 year old presents with shortness of breath and subject high blood pressure. Initial BP in the emergency department is 205/101 and pulse 105. He is admitted to the ICU. During his hospitalization an echocardiogram reveals a left ventricular ejection fraction of 40% and grade I diastolic dysfunction.  Which combination of medications is most appropriate to begin prior to discharge?