A 73-Year-Old Lady with Congestive Heart Failure Is Being Readied

A 73-year-old lady with congestive heart failure is being readied for hospital release. The patient has heart failure with a low ejection fraction and has been hospitalized twice in the last 60 days. The patient's medical history includes ischemic heart disease, chronic obstructive lung disease, and hypertension. Vital indicators are typical. A pulmonary examination reveals normal breathing effort, no crackles, and no peripheral edema. The patient asks to stay in the hospital for a few additional days and says, "I feel fine right now, but I am worried that if I go home, I might end up back in the hospital again." Which of the following responses to this patient's request is most appropriate?

A) "Managing heart failure at home can be difficult.  What family members are nearby who can help?"
B) "Since you are worried about going home, would you like to go to a nursing home until you feel more confident?"
C) "Some people with heart failure have problems due to too much salt intake.  Can you tell me about your diet?"
D) "What do you think are some reasons why your heart failure might be worse at home?"
E) "Your condition has now stabilized.  What benefit are you hoping to gain from a continued stay?"