The Patient with CHF/AFib
You are the primary care nurse practitioner in a busy family practice. The patient is a 72-year-old female with a CHA2DS2 VASc score of 6. She was recently hospitalized for CHF and was found to be in rapid AFib. She was diuresed while inpatient and placed on Lasix (furosemide) 20 mg once a day, Coumadin 5 mg once a day, and https://blog.keenessays.com/2021/06/17/in-this-assignment-you-will-explore-the-concept-of-moral-values-moral-motivation-and-what-impact-they-have-on-ethical-behavior/ Toprol XL (metoprolol extended release) 50 mg once a day in addition to her Metformin (glucophage) 500 mg once a day, Zestril (lisinopril) 2.5 mg once a day, and Womens Multivitamin once a day. She is in your office today, five days after discharge. Her last INR was two days ago, and it was 2.7. Her PT and PTT were in range. Her weight is 153 pounds.
She reports to you that she no longer drives and has difficulty obtaining rides to get to the lab. She wants to know if you could change her to one of the novel anticoagulants that her friend is on.
How do you respond?
Please provide patient education about the new medication and any side effects of which she should be aware.

Important Instruction about the Assignment 
1. The paper should always have an introduction statement that explains what the paper will entails.
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