A nurse inadvertently administers 160 mg of valsartan PO to a client who was scheduled to receive 80 mg.
Which of the following actions is the priority for the nurse to take?
A.
Monitor the client’s urine output
B.
Check the client for nasal congestion
C.
Evaluate the client for orthostatic hypotension
D.
Obtain the client’s laboratory results
The Correct answer and Explanation is:
The correct answer is C. Evaluate the client for orthostatic hypotension.
Explanation:
Valsartan is an angiotensin II receptor blocker (ARB) commonly used to manage hypertension and heart failure. Administering a double dose of valsartan (160 mg instead of 80 mg) increases the risk of adverse effects, particularly those related to blood pressure.
- Assess for Orthostatic Hypotension:
- Valsartan can cause significant drops in blood pressure, especially when taken in higher doses. Orthostatic hypotension, a condition where blood pressure drops upon standing, can occur, leading to symptoms such as dizziness, lightheadedness, or fainting. This is a critical concern because the client could be at risk of falls or other complications due to this drop in blood pressure.
- Monitoring for orthostatic hypotension involves checking the client’s blood pressure and heart rate while lying down, sitting, and standing to identify any significant changes. Early detection allows for timely intervention to prevent complications.
- Monitoring Urine Output:
- While monitoring urine output (Option A) is important for assessing kidney function, it is less immediate in addressing the acute risk of hypotension from an overdose of valsartan. This can be crucial later on if kidney function becomes a concern, but it does not directly address the immediate risk of hypotension.
- Checking for Nasal Congestion:
- Nasal congestion (Option B) is not a common side effect of valsartan, especially in the context of an overdose. Hence, it is less relevant compared to the risk of hypotension.
- Obtaining Laboratory Results:
- Obtaining laboratory results (Option D) might provide information about the client’s renal function and electrolyte balance, which are relevant for long-term management and assessment. However, the immediate priority is to address the acute risk of hypotension rather than waiting for laboratory results.
In summary, the immediate priority is to evaluate the client for orthostatic hypotension, given the increased risk of a significant drop in blood pressure from the valsartan overdose. Prompt assessment and intervention are crucial to manage and mitigate potential complications associated with the overdose.