A nurse recognizes that alterations in cardiac output are caused by changes in heart rate, preload, afterload, and contractility. Which interventions are correctly matched to treat the cause of low cardiac output? Select all that apply.
a) Low afterload: administer vasopressor.
b) Low afterload: administer vasodilator.
c) Low right atrial (R

Choice A reason: Albumin is a plasma expander and is typically used to restore blood volume in cases of shock, burns, or trauma. However, it is not specifically indicated for managing spinal shock. Albumin helps in maintaining osmotic pressure and fluid balance but does not directly address the underlying pathophysiology of spinal shock.

Choice B reason: Nitroprusside is a potent vasodilator used to manage hypertensive crises. It works by rapidly reducing blood pressure through vasodilation. In the context of spinal shock, where hypotension is a concern, administering nitroprusside would be inappropriate as it could exacerbate the hypotensive state and worsen the patient's condition.

Choice C reason: Dexamethasone, a corticosteroid, is used to reduce inflammation and edema around the spinal cord following an injury. The anti-inflammatory properties of dexamethasone help to mitigate secondary damage caused by swelling and pressure on the spinal cord tissue. It is commonly administered in cases of acute spinal cord injuries to improve neurological outcomes and manage symptoms of spinal shock.

Choice D reason: Furosemide is a diuretic used to manage fluid overload and edema. It works by increasing urine output, which can help reduce fluid retention in various conditions, such as heart failure and renal impairment. However, it is not specifically indicated for the management of spinal shock and does not address the underlying causes of spinal cord injury-related inflammation and edema.

Choice A reason: Decreased cardiac arrhythmias are not the primary desired effect of dobutamine in heart failure patients. While dobutamine can have some effects on heart rhythm, its main action is to increase the strength of the heart's contractions.

Choice B reason: Increased myocardial contractility is the correct and desired effect of dobutamine. Dobutamine is a positive inotropic agent, meaning it increases the force of the heart's contractions. This is particularly beneficial in heart failure patients as it helps improve cardiac output and the effectiveness of the heart as a pump, thus alleviating symptoms of heart failure and improving organ perfusion.

Choice C reason: Decreased electrical conductivity in the heart is not an effect of dobutamine. In fact, dobutamine can increase the risk of arrhythmias due to its stimulating effects on the heart. The drug works by enhancing the contractility of the heart muscle rather than altering the electrical conduction system.

Choice D reason: Dilated coronary arteries are not a primary effect of dobutamine. While the drug may have some vasodilatory properties, especially at higher doses, its primary role is to enhance myocardial contractility rather than directly dilate the coronary arteries.