رجل عمره ٦٤ سنة عنده فشل قلب، يأخذ فوروسيمايد ٤٠ ملغ صباحاً وميتوبرولول مرتين يومياً، ويريد صيام رمضان الذي يبدأ بعد أسبوعين في الصيف. وزنه مستقر، وضغطه ١١٨/٧٢. أي نصيحة يعطيها الممرض أولاً؟

A 64-year-old man with heart failure takes furosemide 40 mg each morning and metoprolol twice daily and wants to fast Ramadan, starting in two weeks in summer. His weight is stable and BP 118/72. What advice does the nurse give first?

1. Take all his medicines together in one go at suhoor
2. See the doctor before Ramadan to adjust timing and assess fasting
3. Stop all his medicines during Ramadan and restart after Eid
4. Fast with no changes and drink a great deal of water at iftar

Answer: B) See the doctor before Ramadan to adjust timing and assess fasting. Many cardiac patients can fast after medical review, with doses moved between iftar and suhoor. Stopping or bunching drugs risks decompensation or hypotension, and drinking large volumes at once can worsen congestion.