Sodium nitroprusside used in hypertensive emergencies has which major risk requiring monitoring?

Sodium nitroprusside used in hypertensive emergencies has which major risk requiring monitoring?

• A. Hypertension
• B. Hyperglycemia
• C. Hypotension
• D. Tachycardia

Answer: (C)

Sodium nitroprusside is a potent, rapidly acting vasodilator used in hypertensive emergencies. Because it dilates both arteries and veins so quickly, blood pressure can drop too much if the infusion isn’t watched closely. The major risk requiring monitoring is a rapid decrease in blood pressure (hypotension), which can reduce blood flow to vital organs. To prevent this, blood pressure is monitored continuously—often with an arterial line—and the infusion is titrated carefully to keep pressures within a safe range. Reflex tachycardia can accompany the drop in pressure, so heart rate monitoring is also important. While cyanide toxicity is a consideration with prolonged use, the immediate and most critical monitoring focus is avoiding hypotension.

Sodium nitroprusside is a potent, rapidly acting vasodilator used in hypertensive emergencies. Because it dilates both arteries and veins so quickly, blood pressure can drop too much if the infusion isn’t watched closely. The major risk requiring monitoring is a rapid decrease in blood pressure (hypotension), which can reduce blood flow to vital organs. To prevent this, blood pressure is monitored continuously—often with an arterial line—and the infusion is titrated carefully to keep pressures within a safe range. Reflex tachycardia can accompany the drop in pressure, so heart rate monitoring is also important. While cyanide toxicity is a consideration with prolonged use, the immediate and most critical monitoring focus is avoiding hypotension.