Page 1786 - Saunders Comprehensive Review For NCLEX-RN

C. Interventions

1. Monitor vital signs, especially the BP and the heart
rate.
2. Monitor for orthostatic hypotension and tachycardia.
3. Monitor for signs of inadequate blood flow to the
extremities, such as pallor, feeling cold, and pain.
4. Instruct the client that it may take up to 3 months for a
desired therapeutic response.
5. Advise the client not to smoke, because smoking
increases vasospasm.
6. Instruct the client to avoid aspirin or aspirin-like
compounds unless approved by the PHCP.
7. Instruct the client to take the medication with meals if
gastrointestinal disturbances occur.
8. Instruct the client to avoid alcohol, because it may
cause a hypotensive reaction.
9. Encourage the client to change positions slowly to
avoid orthostatic hypotension.
XIV. Direct-Acting Arteriolar Vasodilators (Box 53-17)
A. Description
1. Direct-acting vasodilators relax the smooth muscles of
the blood vessels, mainly the arteries, causing
vasodilation; with vasodilation, the BP drops and
sodium and water are retained, resulting in
peripheral edema (diuretics may be given to decrease
the edema).
2. Direct-acting vasodilators promote an increase in
blood flow to the brain and kidneys.
3. These medications are used in the client with
moderate to severe hypertension and for acute
hypertensive emergencies.
B. Side and adverse effects

1. Hypotension
2. Reflex tachycardia caused by vasodilation and the
drop in BP
3. Palpitations
4. Edema
5. Dizziness
6. Headaches
7. Nasal congestion
8. Gastrointestinal bleeding
9. Neurological symptoms
10. Confusion
11. With sodium nitroprusside, cyanide toxicity and
thiocyanate toxicity can occur.

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