👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Pharmacological Therapies🔖 Free to read, print, and share
Also known as: Apresoline · direct vasodilator
💡
Use this quick-reference guide to spot, treat, and prevent Hydralazine on the NCLEX. Keep it handy during review and on exam day!
🩺
📒 The 1-minute cheat sheet
📌 Uses
Severe HTN, HTN in pregnancy
Dilates arterioles → ↓ afterload
🩺 Signs
Reflex tachycardia, palpitations
Headache, flushing, hypotension
🚩 Report
Lupus-like: joint pain, rash, fever
Chest pain, HR > 100
📌 Avoid
Caution in CAD → ↑ O2 demand
Often paired w/ beta-blocker
🎓 Teach
Take with food, rise slowly
Monitor BP & HR, daily weight
📚 Hydralazine — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Hydralazine is a direct-acting arterial vasodilator used for hypertension, hypertensive emergencies, and, combined with isosorbide dinitrate, for heart failure (especially in Black patients). It relaxes arteriolar smooth muscle to reduce afterload and lower blood pressure. Reflex tachycardia is a common, predictable response.
🔑
Key points
Understand these first
Directly relaxes arteriolar smooth muscle, lowering blood pressure and afterload.
Causes reflex tachycardia, so it is often paired with a beta blocker to blunt the heart-rate increase.
Long-term high-dose therapy can cause a drug-induced lupus-like syndrome (joint pain, fever, rash).
Used in pregnancy-related hypertension and preeclampsia as an IV option.
Combined with isosorbide dinitrate (BiDil) it improves outcomes in heart failure, particularly in self-identified Black patients.
Orthostatic hypotension and headache are common early effects.
✅
Nursing priorities
What to do, in order
Monitor blood pressure and heart rate before and after dosing; hold for hypotension per parameters.
Assess for reflex tachycardia and report sustained increases.
Watch for lupus-like symptoms such as joint pain, fever, and rash during long-term therapy.
Teach the patient to change positions slowly to avoid orthostatic dizziness.
Report severe hypotension or rapid heart rate with palpitations or chest pain.
Do not stop abruptly, which can cause rebound hypertension.
🗣️
Patient teaching
What patients must know
Take your blood pressure and pulse as instructed and report a fast heart rate or dizziness.
Rise slowly from lying or sitting to prevent fainting.
Report joint pain, unexplained fever, fatigue, or a new rash, which may signal a lupus-like reaction.
Take the medication consistently and do not stop suddenly.
Headache and flushing are common early and usually lessen over time.
❓ Hydralazine: NCLEX FAQs
What are the priority nursing interventions for Hydralazine?
Monitor blood pressure and heart rate before and after dosing; hold for hypotension per parameters. Assess for reflex tachycardia and report sustained increases. Watch for lupus-like symptoms such as joint pain, fever, and rash during long-term therapy. Teach the patient to change positions slowly to avoid orthostatic dizziness.
What are the warning signs of Hydralazine a nurse must report?
Report joint pain, prolonged fever, malaise, or facial rash suggesting drug-induced lupus. Report severe hypotension or rapid heart rate with palpitations or chest pain. Do not stop abruptly, which can cause rebound hypertension.
What do I need to know about Hydralazine for the NCLEX?
Directly relaxes arteriolar smooth muscle, lowering blood pressure and afterload. Causes reflex tachycardia, so it is often paired with a beta blocker to blunt the heart-rate increase. Long-term high-dose therapy can cause a drug-induced lupus-like syndrome (joint pain, fever, rash). Used in pregnancy-related hypertension and preeclampsia as an IV option.
What patient teaching is important for Hydralazine?
Take your blood pressure and pulse as instructed and report a fast heart rate or dizziness. Rise slowly from lying or sitting to prevent fainting. Report joint pain, unexplained fever, fatigue, or a new rash, which may signal a lupus-like reaction. Take the medication consistently and do not stop suddenly.
✨
Quick Tip
Directly relaxes arteriolar smooth muscle, lowering blood pressure and afterload.