Which is a priority nursing diagnosis for a client taking an antihypertensive medication?

• A. Alteration in cardiac output related to effects on the sympathetic nervous system
• B. Knowledge deficit related to medication regimen
• C. Fatigue related to side effects of medication
• D. Alteration in comfort related to nonproductive cough

Answer: (A)

The priority concept is that antihypertensive meds can change cardiac output by influencing the sympathetic nervous system, so preserving adequate perfusion is the top nursing priority. These drugs can slow the heart, reduce contractility, or lower vascular resistance, all of which can lower cardiac output. If perfusion drops, organs may not receive enough blood, posing an immediate safety risk.

A nursing diagnosis that describes Alteration in cardiac output related to effects on the sympathetic nervous system directly targets this risk, guiding the nurse to monitor vital signs, color and temperature of extremities, urine output, and signs of impaired perfusion, and to respond promptly to hypotension or bradycardia.

Education about the regimen and attention to side effects like fatigue or a nonproductive cough are important, but they do not address the immediate threat to perfusion as directly as the cardiac output concern.