A nursing student asks a nurse why a patient in hypertensive ...

[bobthebuilder]

A nursing student asks a nurse why a patient in hypertensive crisis is receiving both intravenous sodium nitroprusside (Nitropress) and oral hydralazine (Apresoline). The nurse will explain that this is done to prevent:
 
  a. cyanide poisoning.
  b. fluid retention.
  c. rebound hypertension.
  d. reflex tachycardia.

Question 2

A female patient with essential hypertension is being treated with hydralazine (Apresoline) 25 mg twice daily.
 
  The nurse assesses the patient and notes a heart rate of 96 beats per minute and a blood pressure of 110/72 mm Hg. The nurse will request an order to:
  a. administer a beta blocker.
  b. administer a drug that dilates veins.
  c. reduce the dose of hydralazine.
  d. give the patient a diuretic.

[emily12345]

Answer to Question 1

ANS: C
Sodium nitroprusside acts rapidly and is given only intravenously. Rebound hypertension occurs immediately when the IV is stopped, so an oral antihypertensive should be given simultaneously. Cyanide poisoning can occur with sodium nitroprusside, but giving hydralazine does not counter this adverse effect. Hydralazine does not prevent fluid retention or reflex tachycardia.

Answer to Question 2

ANS: A
This patient is showing signs of reflex tachycardia, so a beta blocker is indicated to slow the heart rate. Patients with heart failure who take hydralazine often require the addition of isosorbide dinitrate, which also dilates veins. There is no indication for reducing the dose of hydralazine. A diuretic can be given with hydralazine if sodium and water retention is present.

[bobthebuilder]

TYSM

[ghepp]

Gracias!