Final answer:
During vasopressin IV infusion for bleeding esophageal varices, the nurse should monitor for signs of hypertension, volume status changes such as hypovolemia or hypervolemia, and symptoms indicating hypoxia or adverse effects like nausea or changes in heart rate.
Step-by-step explanation:
A nurse monitoring a client with bleeding esophageal varices who receives vasopressin (Pitressin) IV should closely observe for several important effects. Vasopressin, used to lower blood pressure in hypertensive crises, can also cause vasoconstriction and thus reduce portal blood flow, helping to control bleeding varices. However, due to this vasoconstrictive effect, the medication can lead to potential complications such as hypertension, hypovolemia, and transient hypoxia in some tissues.
The nurse should closely monitor the client's vital signs, especially blood pressure and heart rate, to identify signs of hypertension or shock. Observing for signs of hypoxemia, such as changes in mental status or oxygen saturation levels, is also necessary. Additionally, vasopressin can result in hypervolemia, so assessment for signs of fluid overload is important. The nurse should be alert for symptoms like nausea, vomiting, or a change in heart rhythm, indicating adverse effects of the drug and possibly affecting the hepatic vein and inferior mesenteric artery flow.