Which first-line medication would the nurse anticipate being in the plan of care for a patient with systolic heart failure to reduce vasoconstriction and afterload?
A) Diuretics
B) Nitrates
C) Beta blocker
D) ACE inhibitor
D) ACE inhibitor
Explanation: A) Diuretics, such as the loop diuretic furosemide, reduce sodium resorption in the kidneys, thereby promoting diuresis and relieving symptoms related to congestion. Diuretics are not first-line therapy for heart failure.
B) Vasodilators, such as nitrates, directly relax vascular smooth muscle, leading to vasodilation. Nitrates typically affect the venous system, reducing preload. Vasodilators are not first-line therapy for heart failure.
C) Beta blockers are used in the treatment of systolic heart failure to block the effects of beta-adrenergic stimulation on the heart and blood vessels. Blocking the beta receptors helps to reduce vasoconstriction and heart rates, reducing blood pressure and allowing more time for ventricular filling. They are not first-line therapy for heart failure.
D) Treatment of systolic heart failure is aimed at reducing symptoms by decreasing fluid retention and counteracting the neurohormonal effects of heart failure. ACE inhibitors are considered first-line therapy in the treatment of systolic heart failure. ACE inhibitors block the conversion of angiotensin I to angiotensin II, thereby decreasing vasoconstriction and reducing afterload.
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