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

Choice A reason: Decreased cardiac output would result in a decrease in blood pressure, not an increase. Cardiac output is the amount of blood pumped by the heart per minute.

Choice B reason: Decreased vascular resistance would also result in a decrease in blood pressure, not an increase. Vascular resistance is the force that opposes the blood flow in the blood vessels.

Choice C reason: Hypovolemia would also result in a decrease in blood pressure, not an increase. Hypovolemia is the condition of having low blood volume due to fluid loss or dehydration.

Choice D reason: Vasoconstriction would result in an increase in blood pressure. Vasoconstriction is the narrowing of the blood vessels, which increases the vascular resistance and the blood pressure.

Choice A reason: This is not the agent that the nurse should question. Beta blockers are a class of medications that lower the blood pressure and heart rate by blocking the beta receptors in the heart and blood vessels. They can be used to treat hypertension, angina, heart failure, and arrhythmias. They do not cause edema or hyperkalemia.

Choice B reason: This is not the agent that the nurse should question. Alpha 2 agonists are a class of medications that lower the blood pressure by stimulating the alpha 2 receptors in the brain, which reduce the sympathetic nervous system activity. They can be used to treat hypertension, especially in patients with renal impairment. They do not cause edema or hyperkalemia.

Choice C reason: This is not the agent that the nurse should question. Calcium channel blockers are a class of medications that lower the blood pressure and heart rate by blocking the calcium channels in the heart and blood vessels, which cause vasodilation and reduced cardiac contractility. They can be used to treat hypertension, angina, and arrhythmias. They may cause edema, but not hyperkalemia.

Choice D reason: This is the agent that the nurse should question. Aldosterone antagonists are a class of medications that lower the blood pressure and reduce fluid retention by blocking the action of aldosterone, a hormone that regulates the sodium and potassium balance in the body. They can be used to treat hypertension and heart failure, especially in patients with low renin levels. However, they can cause hyperkalemia, which can be dangerous for the patient. The nurse should question the prescriber about the rationale for prescribing this agent and monitor the patient's potassium level closely.