Helen Edwards is a 44-year-old African American woman who presents to the emergency department with headache and shortness of breath. Helen has a long-standing history of HTN. She has never...

Helen Edwards is a 44-year-old African American woman who presents to the emergency department with headache and shortness of breath. Helen has a long-standing history of HTN. She has never consistently adhered to any HTN management strategies and has been nonadherent with her medication regimen for the past 8 months. Upon arrival at the emergency department her blood pressure is 192/126 mmHg. When you assess the patient, it is noted that she is approximately 1.7 m (5’6”) in height and the self-reported weight is 107 kg (235 lb). She is slightly lethargic and reports having left arm numbness and tingling. Other physical assessment parameters are normal. Helen is started on an infusion of nitroprusside (Nipride) 50 mg in 250 mL in D 5 W. The dose will be titrated between 0.5 to 10 mcg/kg/min to maintain the patient’s diastolic pressure at less than 100 mmHg.

1. Describe the mechanism of action related to nitroprusside (Nipride).

2. For what adverse effects should you monitor in patients receiving this drug therapy?

3. What factors does this patient have that predisposes her to hypertensive crises?