As the nurse taking care of a patient on vasodilator therapy, what do you want to monitor for?

Choice A rationale Developing a fever is typically a sign of an underlying infection or an inflammatory response. While it is important to monitor the temperature of any hospitalized patient, it is not a direct consequence of vasodilator therapy. Vasodilators act on the smooth muscle of blood vessels to decrease resistance and are not pyrogens. Normal body temperature is approximately 98.6 degrees Fahrenheit. A fever would suggest a different complication entirely, such as a site infection or pneumonia. Choice B rationale Vasodilators are designed to relax the blood vessels, which reduces systemic vascular resistance and afterload. While this helps the heart pump more easily, it can lead to an excessive drop in blood pressure or a decrease in cardiac output if the vessels dilate too much. The nurse must monitor for hypotension, which is a systolic pressure below 90 mmHg. If the blood pressure falls too low, vital organs may not receive enough oxygenated blood for proper function. Choice C rationale An increase in fluid retention is a common side effect of some vasodilators, particularly those that activate the renin-angiotensin-aldosterone system as a compensatory mechanism. When blood pressure drops, the kidneys may attempt to hold onto sodium and water to increase volume. However, monitoring for a decrease in cardiac output and blood pressure is a more immediate safety priority for patients on these medications. Normal serum creatinine is 0.6 to 1.2 mg per deciliter to monitor kidney function. Choice D rationale An increase in blood pressure is the opposite of the intended effect of vasodilator therapy. These medications are specifically administered to lower blood pressure or reduce the workload on a failing heart. If the blood pressure increases, the medication may be ineffective, the dose may be too low, or the patient may be experiencing a paradoxical reaction. The nurse monitors to ensure the blood pressure stays within the target range prescribed by the healthcare provider.