Student Name:_________________ Date:_________________
Medication Trade Name: Hydralazine
Medication Generic Name: Hydralazine
Medication Class: Func. class.: Antihypertensive, direct-acting peripheral vasodilator
Chem. class.: Phthalazine
Scenario
Number
Dose, Route,
Adult: PO 10
&
mg qid 2-4
Frequency:
days, then 25
mg for rest of
1st wk, then 50
mg qid, max
300 mg/day
Medication Action: Vasodilates arteriolar smooth muscle by direct relaxation; reduction in blood
pressure with reflex increases in heart rate, stroke volume, cardiac output
Side Effects/Adverse Reactions:
Common: CNS: Headache, dizziness
CV: Palpitations, tachycardia, angina
Gl: Nausea, vomiting, anorexia, diarrhea
MlSC: Lupuslike symptoms
Indication for use with this client:
Scenario
Number
Why is this
Preclampsia
prescribed?
Nursing Implications for this client (additional space on the back of the form):
Assess:
• Cardiac status: B/P q15min × 2 hr, then q1hr × 2 hr, then q4hr after IV dose; pulse, jugular venous
distention q4hr, after IV administration
• Electrolytes, blood studies: potassium, sodium, chloride, carbon dioxide, CBC, serum glucose, LE prep,
ANA titer before, during treatment; assess for fever, joint pain, rash, sore throat (lupuslike symptoms);
notify prescriber
• Number of refills to determine compliance
• Weight daily, I&O, edema in feet, legs daily, skin turgor, dryness of mucous membranes for hydration
status
• For renal disease: dosage and administration are altered in reduced CCr, dialysis
• Crackles, dyspnea, orthopnea
• IV site for extravasation, rate
• Mental status: affect, mood, behavior, anxiety; check for personality changes
• Beers: use with caution in older adults; may exacerbate syncope in those with a history of syncope
• Pregnancy/breastfeeding: use only if benefits outweigh fetal risk; 3rd-trimester toxicity has occurred;
use caution in breastfeeding
Evaluate:
• Therapeutic response: decreased B/P
Teach patient/family:
• To take with food to increase bioavailability (PO)
• To avoid OTC, herbals, supplements unless directed by prescriber
• To notify prescriber if chest pain, severe fatigue, fever, muscle or joint pain, rash, sore throat; tingling,
pain in hands, feet, pyridoxine can be used
• To rise slowly to prevent orthostatic hypotension
• That follow-up will be needed; to comply with other requirements, such as exercise, weight loss,
avoidance of smoking
• To notify providers of product use prior to surgery
• To avoid driving or other hazardous activities until response is known; drowsiness, dizziness may
occur
• To weigh 2× per wk and check lower extremities for swelling
• To take as prescribed, not to skip or double doses, to take at the same time of the day, if dose is
missed, take when remembered, do not discontinue abruptly
• To notify prescriber if pregnancy is suspected or planned or if breastfeeding
Safe Dose & Frequency: PO 10 mg qid 2-4 days, then 25 mg for rest of 1st wk, then 50 mg qid, max
300 mg/day
Administration Rate & Dilution (IV or liquid medication only): • IV undiluted; give through Y-tube
or 3-way stopcock, give each 10 mg over ≥1 min
Treatment of Overdose (if applicable): Administer vasopressors, volume expanders for shock; if PO,
lavage if recently ingested, digitalization
Pertinent Lab Value to Monitor: Decrease: HB, WBC, RBC, platelets, neutrophils
Positive: ANA titer