What is the priority assessment for a patient receiving IV nesiritide (Natrecor) to treat heart failure?

• A. Urine output
• B. Lung sounds
• C. Blood pressure
• D. Respiratory rate

Answer: (C)

Nesiritide is a vasodilator used in acute heart failure, so the most important thing to monitor is blood pressure. Its effect is to lower systemic vascular resistance and blood pressure, which can lead to hypotension and reduced organ perfusion. Therefore, checking the patient's BP closely during the IV infusion is essential to detect hypotension early and adjust or stop the infusion if needed. While urine output, lung sounds, and respiratory rate provide useful information about fluid status and pulmonary congestion, they do not carry the same immediate safety risk as a potential drop in blood pressure with this therapy.