Heather is a 51-year-old female who is admitted for inpatient support of worsening liver function. She has chronic

hepatitis B and has been infected now with hepatitis D. She has significant ascites and when you examine her you appreciate a respiratory rate of 28 b.p.m. Heather reports subjective shortness of breath with even minimal exertion such as getting out of bed. Which of the following actions is indicated?

An arterial blood gas

Lactulose 30 mg daily x 4 days

Paracentesis

Fluid restriction of 750 mL/24 hour period