Question

A client in hypertensive emergency is being cared for in the ICU. The client has become hypovolemic secondary to natriuresis. What is the nurse's most appropriate action?

a. Add sodium to the client's IV fluid, as prescribed.
b. Administer a vasoconstrictor, as prescribed.
c. Promptly cease antihypertensive therapy.
d. Administer normal saline IV, as prescribed.

Answer 1

The nurse should administer normal saline IV to a hypovolemic hypertensive emergency patient, as this directly restores fluid and electrolyte balance.

Step-by-step explanation:

The most appropriate action for a nurse caring for a client in hypertensive emergency who has become hypovolemic secondary to natriuresis is to administer normal saline IV, as prescribed. This will help to restore fluid balance by replacing lost water and sodium. The administration of normal saline addresses the hypovolemic state directly, whereas adding sodium alone might not adequately replenish the fluid volume. Furthermore, ceasing antihypertensive therapy abruptly could be dangerous, and administering a vasoconstrictor could exacerbate the hypertensive state.

Angiotensin II is a powerful vasoconstrictor that not only increases blood pressure but also stimulates aldosterone production, leading to the reabsorption of sodium and water by the kidneys. This process is important for the maintenance of normal blood pressure and vascular volume. In a hypovolemic patient, therefore, the correction of fluid and electrolyte loss is crucial, often involving a solution that could be a mixture of isotonic saline and Na lactate intravenously, as appropriate.