A nurse is educating a patient with a productive cough about taking an expectorant. The nurse explains the importance of drinking a full glass of water with the medication. Which statement by the patient indicates a need for further education on expectorant use?

A. Inhibits the renin-angiotensin-aldosterone system:Hydralazine does not act on the RAAS pathway and does not block angiotensin-converting enzyme or angiotensin receptors. Medications such as ACE inhibitors or ARBs are responsible for this mechanism. Hydralazine works peripherally on vascular smooth muscle.

B. Promotes sodium and water retention:Sodium and water retention can occur as a compensatory adverse effect rather than a therapeutic action of hydralazine. This response is related to reflex activation of the sympathetic nervous system and RAAS. It does not explain the drug’s blood pressure–lowering effect.

C. Increases heart rate to improve cardiac output:Reflex tachycardia may occur secondary to vasodilation, but it is not the intended or primary mechanism of action. Increasing heart rate can increase myocardial oxygen demand and is often an undesirable effect. This action does not directly reduce blood pressure.

D. Directly causes arterial vasodilation to decrease blood pressure:Hydralazine relaxes arterial smooth muscle, leading to decreased systemic vascular resistance. This arterial vasodilation lowers afterload and rapidly reduces blood pressure in hypertensive crises. The effect is direct and does not rely on hormonal pathways.

A. Verify the medication and dose with another nurse before administration: High-alert medications carry a higher risk of causing significant harm if used incorrectly. Independent double-checking by another nurse ensures correct drug, dose, route, and patient, reducing the risk of serious medication errors.

B. Administer the medication without a second nurse check: Skipping a double-check increases the risk of administering an incorrect dose or medication. High-alert drugs require verification procedures because errors can have severe or fatal consequences.

C. Rely on the automated dispensing system to prevent errors: Automated systems reduce errors but are not foolproof. Human verification is still necessary, especially for high-alert medications, to catch potential mistakes that machines may miss.

D. Ask the client if they have taken this medication before: While patient history can provide context, clients may not accurately recall medications or doses. Verification through medical records and independent nurse checks is essential for safe administration.