The patient with acute decompensated heart failure who has gained 5 kg in the past week is severely fluid volume overloaded; intravenous loop diuretics such as bumetanide will be most effective at decreasing plasma volume. Oral hydrochlorothiazide will likely not be strong enough for this patient and is not usually used for this purpose. Hypertonic saline infusion does not address the patient’s fluid volume overload. Although the patient will likely receive subcutaneous heparin injections during his hospitalization, this does not address the patient’s excess fluid volume status.