Review Question - QID 212553

A 69-year-old woman is in the cardiac step-down unit for the management of an ST-elevation myocardial infarction. The patient underwent a percutaneous coronary intervention and had a drug-eluting stent placed. Her hospital course has been complicated by a high premature ventricular contraction (PVC) burden and episodes of wide complex ventricular tachycardia. After appropriate management, she was switched from short-acting metoprolol every 6 hours, to daily long-acting metoprolol in the morning and nightly diltiazem. The patient reports feeling “off” for the past few days. She denies chest pain or palpitations. Telemetry demonstrates very minimal PVCs and otherwise normal sinus rhythm. Physical examination is unremarkable. A complete blood count (CBC), chest radiography, urinalysis, urine culture, and blood culture have been ordered. Laboratory studies are shown below:

Hemoglobin: 13.5 g/dL
Hematocrit: 41%
Leukocyte count: 16,500/mm^3 with normal differential
Platelet count: 170,000/mm^3

Urinalysis
Color: Yellow
Appearance: Hazy
Blood: Negative
pH: 6 (normal 5-8)
Protein: Negative
Nitrite: Negative
Leukocyte esterase: Positive

Urine culture
Preliminary report: > 100,000 CFU/mL of E. coli

Blood culture: Pending

She is started on appropriate oral antibiotic therapy and half an hour later she develops flushing and skin findings demonstrated in Figure A. Pulmonary auscultation is unremarkable, and she otherwise feels fine. Which of the following is the best next step in management?