76-year-old female patient complains of weight gain,

76-year-old female patient complains of weight gain, shortness of breath, peripheral edema, and abdominal swelling. She has a history of congestive heart failure and admits to not taking her diuretic, as it makes her “have to get up every couple hours to go to the bathroom.” She now has to sleep on two pillows in order to get enough air. What type of heart failure is this patient experiencing? Right or left? Or is it a combination? Remember that patients with CHF must be on 5 different medications according to the JNC8 guidelines. These include: ACE/ARB, Beta Blocker, Diuretic, Anti-Platelet/Coagulant, and Statin. Why do these patients need to be on so many medications? What is the benefit of each of these?

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