What type of toxicity must be monitored in a patient receiving a nipride gtt?

In patients receiving a continuous intravenous infusion of sodium nitroprusside (nitroprusside), it's essential to monitor for thiocyanate poisoning. Nitroprusside is metabolized in the body to cyanide and then further metabolized to thiocyanate by the liver. While cyanide toxicity can occur, especially with prolonged use or high doses, thiocyanate is the primary metabolite that builds up with longer administration or in patients with impaired renal function, as thiocyanate is primarily excreted by the kidneys.

Thiocyanate levels can become elevated if nitroprusside is given for prolonged periods or if the dose is high, leading to symptoms of toxicity such as confusion, tinnitus, and lethargy. Therefore, monitoring thiocyanate levels is crucial to prevent its toxicity when administering nitroprusside, particularly for patients receiving the medication for more than 48 hours or those at risk for renal impairment.

While cyanide toxicity is a significant concern, monitoring for thiocyanate levels becomes more relevant in prolonged therapy. Other options like carbon monoxide poisoning and ethylene glycol poisoning are not directly related to nitroprusside use, making thiocyanate the most pertinent toxicity