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

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.

Choice A reason: This is not an adverse effect of ACE inhibitors. Constipation is a common side effect of opioid medications, which slow down the intestinal motility and cause hard stools.

Choice B reason: This is not an adverse effect of ACE inhibitors. Hypokalemia is a low level of potassium in the blood, which can be caused by diuretic medications, such as furosemide or hydrochlorothiazide, which increase the urine output and potassium excretion.

Choice C reason: This is an adverse effect of ACE inhibitors. Chronic cough is a dry, persistent cough that occurs in some patients taking ACE inhibitors, due to the accumulation of bradykinin, a substance that causes inflammation and irritation in the respiratory tract.

Choice D reason: This is not an adverse effect of ACE inhibitors. Nervousness is a common side effect of stimulant medications, such as caffeine or amphetamine, which increase the activity of the central nervous system and cause anxiety, agitation, and insomnia.