In acute HF management, which intervention is used to promote IV diuresis?

• A. Nesiritide recombinant human BNP
• B. IV nitrates
• C. IV diuresis
• D. Oral diuretics

Answer: (C)

In acute decompensated heart failure, the immediate goal is to relieve congestion by rapidly removing excess fluid. The most direct way to achieve this is to promote diuresis with an intravenous diuretic. IV loop diuretics, such as furosemide, act quickly by blocking sodium and water reabsorption in the nephron, which increases urine output and lowers preload. This rapid, controllable diuresis helps alleviate pulmonary edema and dyspnea, which is essential in the acute setting.

Monitoring is important: track urine output, weight, electrolytes, and kidney function, and adjust the dose as needed while watching for potential hypotension or electrolyte disturbances. Other options either don’t primarily cause diuresis (IV nitrates mainly reduce preload via venodilation) or are not the fastest or most reliable way to remove fluid acutely (oral diuretics have slower onset, and nesiritide can aid vasodilation but is not the main approach for brisk diuresis).