A 58-year-old man with chronic heart failure (NYHA Class III) and hypertension is on lisinopril 10 mg daily and metoprolol 50 mg twice daily. His current medications include furosemide 40 mg daily. Recent labs show: serum K+ 5.8 mEq/L, serum creatinine 1.4 mg/dL, BUN 28 mg/dL. He reports persistent orthopnea and ankle edema. What is the most appropriate next step in management?

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