A nurse is caring for a client who is receiving nitroprusside for hypertensive crisis. Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication?

Diuretics are drugs that increase urine output and reduce fluid volume in the body. They lower blood pressure by decreasing the amount of sodium and water in the blood vessels, which reduces the pressure on the walls of the arteries. Diuretics are often the first-line therapy for hypertension, especially for older adults and African Americans.

Choice A is wrong because reaching the goal blood pressure depends on many factors, such as the severity of hypertension, the response to medication, and the lifestyle changes of the client. It may take longer than 2 months to achieve optimal blood pressure control.

Choice C is wrong because limiting alcohol consumption to three drinks a day is not enough to prevent or treat hypertension. Alcohol can raise blood pressure by interfering with the effects of medication, stimulating the nervous system, and increasing fluid retention. The recommended limit for alcohol intake is no more than one drink a day for women and two drinks a day for men.

Choice D is wrong because hypertension cannot be cured with medication. Hypertension is a chronic condition that requires lifelong management and monitoring. Medication can help lower blood pressure, but it does not address the underlying causes of hypertension, such as genetics, obesity, stress, or kidney disease. Lifestyle modifications, such as diet, exercise, weight loss, and smoking cessation, are also essential for preventing complications and improving quality of life.

Normal ranges for blood pressure are:

• Systolic: less than 120 mm Hg

• Diastolic: less than 80 mm Hg

Hypertension is defined as:

• Systolic: 130 mm Hg or higher

• Diastolic: 80 mm Hg or higher

All of the statements by the client indicate alack of understandingof the medication.

Here is why:

Choice A is wrong because hydrochlorothiazide (HCTZ) is a diuretic (water pill) that increases the amount of urine produced and excreted by the kidneys. Taking this medication at bedtime may cause frequent urination at night and disrupt the sleep cycle.It is recommended to take HCTZ in the morning or early afternoon.

Choice B is wrong because HCTZ is prescribed to treat high blood pressure (hypertension), which is a chronic condition that requires long-term management. Stopping the medication abruptly may cause a rebound increase in blood pressure and increase the risk of complications such as stroke, heart attack, or kidney failure.The client should continue taking HCTZ as directed by the doctor, even if the blood pressure becomes normal.

Choice C is wrong because a persistent cough is not a common side effect of HCTZ. A cough may be a sign of an allergic reaction, a respiratory infection, or another condition that needs medical attention. HCTZ may cause other side effects such as nausea, dizziness, headache, low blood pressure, low potassium levels, high calcium levels, or skin rash.The client should report any unusual or bothersome symptoms to the doctor.

Choice D is wrong because HCTZ is not a medication that can be taken as needed for symptoms of high blood pressure. High blood pressure often has no symptoms and can damage the blood vessels and organs over time. HCTZ works by reducing the fluid volume and pressure in the blood vessels.It needs to be taken regularly and consistently to maintain its effectiveness and prevent fluctuations in blood pressure. The client should be educated about the purpose, benefits, risks, and instructions of taking HCTZ. The client should also be advised to monitor their blood pressure, weight, fluid intake and output, and electrolyte levels while on this medication.The client should also be counseled about lifestyle modifications such as diet, exercise, stress management, and smoking cessation that can help lower blood pressure and improve overall health.