For an admitted patient showing symptomatic heart failure, which medication should the nurse practitioner administer first?

In the context of symptomatic heart failure, the primary goal is to alleviate the symptoms and improve the overall condition of the patient, particularly managing fluid overload. Furosemide, a loop diuretic, is often the first-line treatment for acute heart failure with congestion. It effectively reduces fluid retention by promoting diuresis, leading to decreased blood volume and lowering the strain on the heart. This can help alleviate symptoms such as shortness of breath and peripheral edema, which are common in heart failure patients.

The other medications listed, while important in the overall management of heart failure, serve different purposes. Metoprolol, a beta-blocker, is used for long-term management and to improve heart function over time, but it is not the immediate solution in an acute setting with symptom exacerbation. Acetylsalicylic acid (aspirin) primarily functions as an antiplatelet agent and does not directly address heart failure symptoms. Lisinopril, an ACE inhibitor, is beneficial for improving heart function and reducing mortality in heart failure patients, but it takes time to provide therapeutic effects. Thus, the acute response to symptoms of heart failure makes furosemide the most appropriate initial choice.