The forward effects in a patient with left ventricular heart failure include (Select all that apply)

Choice A reason: This is not a correct statement. LABAs stand for long-acting beta2-agonists, which are a class of medications that relax the smooth muscles of the airways and improve the airflow in patients with asthma or COPD. However, LABAs do not reduce the risk of asthma-related deaths, and may even increase it if used alone without an inhaled glucocorticoid, which is a type of anti-inflammatory medication.

Choice B reason: This is not a correct statement. LABAs cannot be used on an as-needed basis to treat symptoms, as they have a slow onset of action and a long duration of effect. LABAs are meant to be used as a maintenance therapy to prevent asthma exacerbations, not to relieve acute symptoms. For quick relief of symptoms, patients should use a short-acting beta2-agonist, such as albuterol or salbutamol.

Choice C reason: This is not a correct statement. LABAs are not safer than short-acting beta2 agonists, as they have similar side effects, such as tachycardia, tremors, and hypokalemia. LABAs also have a black box warning that they may increase the risk of asthma-related deaths if used without an inhaled glucocorticoid.

Choice D reason: This is the correct statement. LABAs should be combined with an inhaled glucocorticoid, as this combination has been shown to improve the asthma control, reduce the frequency and severity of exacerbations, and decrease the inflammation and airway hyperresponsiveness. The inhaled glucocorticoid also reduces the risk of adverse effects and mortality associated with LABAs.

Choice A reason: Exudative fluid is not the type of fluid drained from the patient. Exudative fluid is a high-protein fluid that results from inflammation or infection of the pleura. It is usually cloudy and contains white blood cells, bacteria, or blood.

Choice B reason: Purulent fluid is not the type of fluid drained from the patient. Purulent fluid is a thick, yellow-green fluid that results from a bacterial infection of the pleura. It is also known as empyema and contains pus and dead tissue.

Choice C reason: Transudative fluid is the type of fluid drained from the patient. Transudative fluid is a low-protein fluid that results from increased hydrostatic pressure or decreased oncotic pressure in the pleural space. It is usually clear and contains few cells or organisms. It can be caused by conditions such as heart failure, cirrhosis, or nephrotic syndrome.

Choice D reason: Infectious fluid is not the type of fluid drained from the patient. Infectious fluid is a general term that can refer to any fluid that contains microorganisms that cause disease. It can be exudative or purulent, depending on the type and severity of the infection.