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.
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.
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