A patient who has been treated with hydralazine (Apresoline) is ...

[jman1234]

A patient who has been treated with hydralazine (Apresoline) is also taking propranolol (Inderal). The nurse understands that the rationale for this concurrent use of the two medications is to
 
  a. prevent rebound hypertension.
  b. prevent reflex tachycardia.
  c. reduce afterload to prevent heart failure.
  d. prevent a drug-induced lupus erythematosustype reaction.

Question 2

A patient with hypertension and heart failure presents to the emergency department complaining of a headache. The vital signs are: BP 189/112, pulse 92, respiration 20, and temp 99 F.
 
  The nurse administers hydralazine (Apresoline) intravenously. Reassessment after administration of the drug reveals these vital signs: BP 135/84, pulse 124, respiration 18, temp 98.8 F. The nurse correctly interprets these results as
  a. rebound hypertension.
  b. reflex tachycardia.
  c. essential hypertension.
  d. postural hypotension.

[zogaridan]

Answer to Question 1

ANS: B
Propranolol is a beta blocker, which is used concurrently with hydralazine to prevent reflex tachycardia, which is common with the use of hydralazine.
Propranolol will not prevent rebound hypertension with hydralazine.
Isosorbide dinitrate (Isordil) would be used to reduce afterload.
Beta blockers do not prevent a drug-induced lupus erythematosustype reaction.

Answer to Question 2

ANS: B
Reflex tachycardia is caused by lowering of the arterial blood pressure. Hydralazine can trigger reflex stimulation of the heart by the sympathetic nervous system, thereby causing cardiac work and myocardial oxygen demand to increase and an increased heart rate.
Rebound hypertension does not occur with vasodilation.
The blood pressure has decreased, therefore essential hypertension is not present.
Postural hypotension results from relaxation in the veins, and hydralazine dilates arterioles.

[jman1234]

TYSM

[Kedrick2014]

Gracias!