A patient has had great difficulty controlling hypertension with standard drug therapy. She says, "My neighbor couldn't get her blood pressure down until the doctor started her on hydralazine (Apresoline). Which response, by the nurse, is indicated?

Question

1. "Because you had rheumatic fever that damaged your heart, this is not a good drug for you."
2. "Your neighbor must be over age 70."
3. "Your lupus diagnosis keeps us from using that drug."
4. "You should not use that drug because you have rheumatoid arthritis."
5. "We try to avoid using hydralazine (Apresoline) because it causes constant coughing."

Answer 1

1,3
Rationale 1: Rheumatic heart disease is a contraindication to use of hydralazine (Apresoline).
Rationale 2: There is no correlation between hydralazine (Apresoline) use and age.
Rationale 3: Lupus is a contraindication to use of hydralazine (Apresoline).
Rationale 4: There is no correlation between hydralazine (Apresoline) use and presence of rheumatoid arthritis.
Rationale 5: There is no correlation between hydralazine (Apresoline) use and coughing.

Global Rationale: Rheumatic heart disease and lupus are contraindications to the use of hydralazine (Apresoline). There is no correlation between hydralazine (Apresoline) use and age or presence of rheumatoid arthritis. It does not cause cough.