A patient newly diagnosed with left-sided heart failure is admitted to the hospital. The nurse will observe this patient closely for:

Choice A reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have no change in blood sugar, but rather a rise in blood sugar.

Choice B reason: Glucocorticoids can cause an increase in blood pressure by promoting sodium and water retention and increasing vascular reactivity. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have a decrease in the blood pressure, but rather a possible increase in the blood pressure.

Choice C reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will have an increase in blood sugar. This is the correct statement that describes the expected effect of glucocorticoids in this patient.

Choice D reason: Glucocorticoids can cause an increase in blood sugar by stimulating gluconeogenesis and inhibiting insulin action. Therefore, a patient with type 1 diabetes who is taking glucocorticoids will not have an increase in the need for carbohydrates, but rather a need for more insulin to control the blood sugar.

Choice A reason: ACE inhibitors do not lower heart rate. They lower blood pressure by blocking the conversion of angiotensin I to angiotensin II, which is a potent vasoconstrictor. Beta blockers are the drugs that lower heart rate and blood pressure.

Choice B reason: ACE inhibitors inhibit vasoconstriction. This is the correct statement that describes the action of these medications. By blocking the angiotensin II formation, they prevent the narrowing of the blood vessels and reduce the resistance to blood flow.

Choice C reason: ACE inhibitors do not increase aldosterone secretion. They decrease it. Aldosterone is a hormone that causes the kidneys to retain sodium and water, which increases blood volume and pressure. By blocking the angiotensin II formation, ACE inhibitors reduce the stimulation of aldosterone secretion and promote sodium and water excretion.

Choice D reason: ACE inhibitors do not promote sodium retention. They promote sodium excretion. As explained above, ACE inhibitors reduce the aldosterone secretion and prevent the kidneys from reabsorbing sodium and water. This lowers the blood volume and pressure.