A nurse is caring for a client with moderate acute decompensated heart failure. The nurse should include which nursing intervention in the care plan?

Administer dobutamine as ordered.
Administer furosemide as ordered.
Decrease myocardial remodelling.
Reduce stress.

Explanation

• First-line therapy generally includes a loop diuretic such as furosemide, which will inhibit sodium chloride reabsorption in the ascending loop of Henle. Diuretics reduce circulating blood volume, diminish preload, and lessen systemic and pulmonary congestion

• The most powerful way to increase contractility of the heart is to use inotropic medications. Principal inotropic agents include dobutamine, milrinone, dopexamine, and digoxin

• Aside from improving ventricular pump performance and reducing myocardial workload, the client also needs to reduce physical and emotional stress

• Even though the legs are edematous, they should not be elevated. Elevating the legs rapidly increases venous return to the heart

• It is not necessary to restrict fluid intake in clients with mild or moderate heart failure. In more advanced cases, however, it is beneficial to limit water to 1000 mL/day

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