LB is a 57 yoF who is admitted to the hospital with complaints of lower extremity tenderness, erythema, and warmth in he

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LB is a 57 yoF who is admitted to the hospital with complaints of lower extremity tenderness, erythema, and warmth in her right leg. She has a d-dimer of 740 ng/mL and positive Doppler ultrasound. Her PMH includes HTN, anxiety, heart failure, dyslipidemia, end stage renal disease, obesity, recurrent yeast infections, and chronic stable angina. Her vitals are ht 5’6, wt 134 kg, temp 98°, HR 71, BP 124/75.
BMP: Na 132, K 4.2, Cl 99, CO2 28, BUN 22, Scr 4.9, Glucose 119
Current medications: Lisinopril 20 mg daily, Metoprolol tartrate 50 mg BID, Xanax 0.25 mg bid, Atorvastatin 40 mg hs, Fluconazole 150 mg daily (for 10 days), Nitroglycerin 0.4 mg SL prn, estradiol patch 0.025mg/24hr