A patient is receiving vasodilator therapy for hypertension. To counter the increase in blood volume caused by prolonged vasodilator therapy, the patient should be concurrently receiving what drug?
a. Intravenous normal saline to increase the fluid volume
b. A diuretic to prevent sodium and water retention
c. A beta-adrenergic blocker (if the patient has a history of heart failure)
d. Nesiritide (Natrecor) to increase preload
B
Vasodilators cause an increase in blood volume secondary to prolonged reduction of blood pres-sure. The increase in volume represents an attempt by the body to restore blood pressure to pre-treatment levels. A diuretic would help reduce fluid retention and, consequently, the blood pres-sure would not increase.
Intravenous normal saline would further increase the amount of fluid in the body and therefore is contraindicated.
A beta blocker also would contribute to an increase in volume; it would be indicated only if ref-lex tachycardia were an issue.
Nesiritide reduces preload; it is a vasodilator used in severe heart failure.
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