<prompt> Please answer with one of the option in the bracket. Write reasoning in between . Write answer in between .Q:A 57-year-old woman presents to the emergency department for laboratory abnormalities detected by her primary care physician. The patient went to her appointment complaining of difficulty using her hands and swelling of her arms and lower extremities. The patient has notably smooth skin that seems to have not aged considerably. Upon seeing her lab values, her physician sent her to the ED. The patient has a past medical history of multiple suicide attempts, bipolar disorder, obesity, diabetes, and anxiety. Her current medications include lithium, insulin, captopril, and clonazepam. The patients laboratory values are below.Serum:Na: 140 mEqLK: 5.2 mEqLCl-: 100 mEqLHCO3-: 20 mEqLBUN: 39 mgdLGlucose: 127 mgdLCreatinine: 2.2 mgdLCa2: 8.4 mgdLThe patient is restarted on her home medications. Her temperature is 99.5F 37.5C, pulse is 80min, blood pressure is 15590 mmHg, respirations are 11min, and oxygen saturation is 97 on room air. Which of the following is the best next step in management?? A: Continue medications and start metformin, B: Continue medications and start furosemide, C: Continue medications and add nifedipine, D: Start lisinopril and discontinue captopril, E: Start valproic acid and discontinue lithium,  <response>: This is a clinical vignette about a 57-year-old woman presenting with difficulty using her hands, swelling of her arms and legs, smooth skin, and abnormal lab values. She has a history of bipolar disorder, obesity, diabetes, and anxiety. Her labs show high BUN and creatinine indicating possible kidney dysfunction. The question is asking for the best next step in management. Based on the information provided, it seems she may have nephrogenic diabetes insipidus given her history of lithium use, so stopping the lithium and starting an alternative mood stabilizer like valproic acid would be the best option. Her other medications should be continued, and starting a diuretic like furosemide could help with the swelling. Metformin and nifedipine do not seem indicated based on the information provided.E: Start valproic acid and discontinue lithium 