Question

An older adult patient with heart failure is volume-depleted and has a low sodium level. The health care provider has ordered valsartan (Diovan), an angiotensin-receptor blocker (ARB). After the initial dose, for what complication does the nurse carefully monitor in this patient?

a. Hypotension
b. Cough
c. Fluid retention
d. Chest pain

Answer 1

After an initial dose of valsartan (Diovan), a nurse should monitor for hypotension in an older adult patient with heart failure, volume depletion, and low sodium.

Step-by-step explanation:

When an older adult patient with heart failure, who is volume-depleted and has a low sodium level, is prescribed valsartan (Diovan), an angiotensin-receptor blocker (ARB), the nurse should closely monitor for hypotension after the initial dose. ARBs like valsartan block the effects of angiotensin II, which is a potent vasoconstrictor that directly increases blood pressure and stimulates the release of aldosterone, leading to sodium and water reabsorption. When angiotensin II's effects are inhibited, there can be a sudden drop in blood pressure, especially in a volume-depleted patient. Therefore, it is paramount to monitor for signs of hypotension such as dizziness, fainting, or an unusually low blood pressure reading.