A client, diagnosed with insulin-dependent diabetes and acute heart failure, was admitted to the hospital for medical management. What are the appropriate pharmacological interventions to help reduce myocardial workload and improve ventricular pump performance?

Explanation

• Morphine IV is often used for clients with acute heart failure. It is not only an anxiolytic and analgesic, but its most important effect is venodilation, which reduces preload.

• Beta-blockers are used to inhibit the effects of the sympathetic nervous system and reduce the oxygen needs of the myocardium.

• Dobutamine is a very useful medication for heart failure because it produces strong beta-stimulatory effects within the myocardium. It increases heart rate, atrioventricular conduction, and myocardial contractility.

• Leukotriene modifiers are used in the treatment of both acute and chronic asthma. This also does not help with workload or pump performance.

• Dantrolene is classified as a direct-acting skeletal muscle relaxant. It is currently the only specific and effective treatment for malignant hyperthermia.

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