Questions: Which assessment is the priority of the nurse caring for a patient receiving IV nesiritide for treatment of heart failure?
Urinary output
Lung sounds
Blood pressure
Respiratory rate
Transcript text: Which assessment is the priority of the nurse caring for a patient receiving IV nesiritide for treatment of heart failure?
Urinary output
Lung sounds
Blood pressure
Respiratory rate
Solution
Answer
The answer is Blood pressure.
Explanation
Option 1: Urinary output
While monitoring urinary output is important in assessing kidney function and fluid balance, it is not the primary concern when administering nesiritide. Nesiritide can cause diuresis, but the immediate priority is to monitor for potential adverse effects on the cardiovascular system.
Option 2: Lung sounds
Lung sounds are important to assess for signs of fluid overload or pulmonary edema in heart failure patients. However, nesiritide primarily affects blood pressure, so monitoring lung sounds is not the top priority.
Option 3: Blood pressure
Nesiritide is a vasodilator used to treat acute decompensated heart failure, and it can cause significant hypotension. Therefore, monitoring blood pressure is the priority to ensure the patient does not experience dangerously low blood pressure levels.
Option 4: Respiratory rate
While respiratory rate is an important vital sign to monitor, it is not directly affected by nesiritide. The primary concern with nesiritide administration is its impact on blood pressure.