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

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.

Choice A reason: This is the correct statement. Non-selective beta-adrenergic blockers can interfere with the signs and symptoms of hypoglycemia (low blood sugar), such as tachycardia, tremors, and sweating. They can also impair the glucose metabolism and insulin secretion in the body. Therefore, patients with diabetes who take non-selective beta-adrenergic blockers need to monitor their blood glucose levels closely and adjust their insulin or oral hypoglycemic agents accordingly.

Choice B reason: This is not a correct statement. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, do not interact with non-selective beta-adrenergic blockers. However, they can reduce the effectiveness of other antihypertensive medications, such as diuretics or ACE inhibitors, by causing fluid retention and decreasing renal blood flow.

Choice C reason: This is not a correct statement. Non-selective beta-adrenergic blockers have a rapid onset of action and can lower the blood pressure within hours of administration. Therefore, patients do not need to wait for a few weeks to see if their dosage is effective. However, they may need periodic follow-up visits to monitor their blood pressure, heart rate, and other vital signs.

Choice D reason: This is not a correct statement. Dizziness is a common side effect of non-selective beta-adrenergic blockers, especially when the patient changes position or stands up quickly. This is due to the orthostatic hypotension (a drop in blood pressure when standing up) caused by the vasodilation effect of the medication. However, this does not mean that the patient should stop taking the medication, as this can cause rebound hypertension and other complications. Instead, the patient should rise slowly from a sitting or lying position, drink plenty of fluids, and report any severe or persistent dizziness to their health care provider.