A client with bleeding esophageal varices receives vasopressin intravenously (IV). Which adverse effect should the nurse monitor for during the IV infusion of this medication?
A.
Decreasing gastrointestinal (GI) cramping and nausea.
B.
Chest pain and dysrhythmia.
C.
Vasodilation of the extremities.
D.
Hypotension and tachycardia.
The correct answer and Explanation is :
The correct answer is B. Chest pain and dysrhythmia.
Explanation:
Vasopressin, also known as antidiuretic hormone (ADH), is used to manage bleeding esophageal varices by constricting blood vessels to reduce portal pressure and control bleeding. However, it can have several adverse effects that require careful monitoring.
Adverse Effects to Monitor:
- Chest Pain and Dysrhythmia (Option B): Vasopressin can cause cardiovascular effects due to its potent vasoconstrictive properties. It can increase systemic vascular resistance and lead to elevated blood pressure. This increased pressure may result in chest pain, myocardial ischemia, or dysrhythmias, especially in patients with pre-existing cardiovascular conditions. Monitoring for these symptoms is crucial to prevent severe complications like myocardial infarction or arrhythmias.
- Decreasing Gastrointestinal (GI) Cramping and Nausea (Option A): While vasopressin can affect gastrointestinal motility, this is not a primary concern during infusion. In fact, the decrease in GI cramping and nausea is not an expected adverse effect to monitor specifically during vasopressin administration.
- Vasodilation of the Extremities (Option C): Vasopressin is a vasoconstrictor, not a vasodilator. It primarily works by constricting blood vessels to manage bleeding varices. Therefore, monitoring for vasodilation of the extremities is not relevant.
- Hypotension and Tachycardia (Option D): Vasopressin typically causes an increase in blood pressure rather than hypotension. Tachycardia may occur due to the increased vascular resistance and potential compensatory mechanisms, but it is not the primary adverse effect to monitor compared to cardiovascular symptoms like chest pain and dysrhythmias.
In summary, when administering vasopressin, the nurse should monitor for chest pain and dysrhythmias due to the medication’s potent vasoconstrictive effects on the cardiovascular system.