A nurse is caring for a client who is receiving nitroprusside for hypertensive crisis. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication?
A.
Hypotension
B.
Bradycardia
C.
Tachycardia
D.
Hypertension
The correct answer and Explanation is :
The correct answer is A. Hypotension.
Explanation:
Nitroprusside is a potent vasodilator used to manage hypertensive crises and control severe hypertension. It works by relaxing the smooth muscles in the blood vessels, leading to vasodilation and a subsequent decrease in blood pressure. While effective, nitroprusside can cause a range of adverse effects, and hypotension is a significant one.
Mechanism of Action:
Nitroprusside acts by releasing nitric oxide, which relaxes the smooth muscle cells in blood vessel walls, leading to dilation of both arterial and venous systems. This decreases systemic vascular resistance and preload, resulting in a reduction in blood pressure. Given its potent effect, the balance between therapeutic and adverse effects can be delicate.
Adverse Effects:
- Hypotension: Due to its potent vasodilatory effects, nitroprusside can cause a rapid and pronounced decrease in blood pressure. This drop in blood pressure can be severe and may result in symptoms such as dizziness, weakness, or even syncope (fainting). Monitoring blood pressure closely is crucial to avoid this adverse effect and adjust the infusion rate accordingly.
- Bradycardia: Although not a common side effect of nitroprusside, bradycardia (slow heart rate) can occur as a compensatory mechanism in response to hypotension or as a secondary effect of the medication. It is less directly associated with nitroprusside compared to hypotension.
- Tachycardia: Tachycardia (rapid heart rate) is less likely to be an adverse effect of nitroprusside itself. However, it can occur as a compensatory response to hypotension, where the heart rate increases to maintain adequate cardiac output despite lower blood pressure.
- Hypertension: Nitroprusside is used specifically to treat hypertension. Therefore, hypertension is not a typical adverse effect of this medication; in fact, it would indicate that the medication is not being effective or administered properly.
Monitoring and Management:
The nurse should continuously monitor the client’s blood pressure while administering nitroprusside and be prepared to adjust the infusion rate to prevent or manage hypotension. In case of severe hypotension, stopping or reducing the dose of nitroprusside and addressing the underlying cause of hypotension is essential. Additionally, supportive measures such as intravenous fluids may be used to stabilize blood pressure.
In summary, hypotension is a critical adverse effect of nitroprusside that requires careful monitoring and management to ensure the client’s safety.