Which precaution is not included when using IV nitroprusside?

When administering IV nitroprusside, it is essential to continuously monitor the patient for a sudden decrease in blood pressure due to the potent vasodilatory effects of the drug. Nitroprusside can cause rapid changes in blood pressure, which can result in dangerous hypotension if not carefully observed. Therefore, ongoing blood pressure monitoring is critical to ensure patient safety and adjust the infusion rate as needed.

Monitoring for thiocyanate toxicity is also a key precaution. Nitroprusside can metabolize to thiocyanate, which can accumulate, especially in patients with poor renal function. Thus, vigilance for signs of toxicity is crucial.

Assessing renal function is important as well, since patients with compromised kidney function may retain thiocyanate, increasing the risk of toxicity.

However, administering IV nitroprusside at a slow rate is not commonly a precaution; in fact, it is often given as a continuous infusion. The rate may be adjusted, but it is not standard treatment to deliberately administer it slowly as a precaution. Instead, the emphasis is on titrating the dose according to the patient's hemodynamic response while using continuous monitoring.