Review Question - QID 213696

A 53-year-old man with a history of type I diabetes mellitus and congestive heart failure presents to the emergency department with confusion. He was brought in by his spouse when she found him confused at home. He has had a cold for the past week but otherwise has been well. His temperature is 99.3°F (37.4°C), blood pressure is 82/68 mmHg, pulse is 157/min, respirations are 33/min, and oxygen saturation is 99% on room air. The patient is given 2 liters of normal saline. He complains of feeling short of breath. His oxygen saturation is 94%, pulse is 100/min, and physical exam is notable for bilateral pulmonary crackles and jugular venous distension. A thoracic ultrasound is demonstrated in Figure A. Laboratory values are ordered as seen below.

Hemoglobin: 15 g/dL
Hematocrit: 44%
Leukocyte count: 16,230/mm^3 with normal differential
Platelet count: 199,550/mm^3

Serum:
Na+: 142 mEq/L
Cl-: 100 mEq/L
K+: 3.1 mEq/L
HCO3-: 6.0 mEq/L
BUN: 24 mg/dL
Glucose: 399 mg/dL
Creatinine: 1.3 mg/dL

Which of the following is the most appropriate next treatment that should be given to this patient?