A nurse is administering nifedipine to a client with gestational hypertension as prescribed by the provider.
Which of the following actions would the nurse take to ensure safe administration of this medication?
Check blood pressure before and after giving the medication
Give the medication with grapefruit juice to enhance absorption
Hold the medication if pulse rate is below 60 beats per minute
Monitor blood glucose levels for signs of hypoglycemia
The Correct Answer is A
The correct answer is choice A. Check blood pressure before and after giving the medication. Nifedipine is an antihypertensive medication that is used to treat gestational hypertension. It lowers blood pressure by relaxing the blood vessels and reducing the workload of the heart. Checking blood pressure before and after giving the medication helps to monitor the effectiveness and safety of the treatment.
Choice B is wrong because grapefruit juice can interact with nifedipine and increase its blood levels, which can cause excessive lowering of blood pressure or other side effects. Grapefruit juice should be avoided when taking nifedipine.
Choice C is wrong because nifedipine does not affect the pulse rate significantly. Holding the medication if pulse rate is below 60 beats per minute is more appropriate for beta-blockers, such as labetalol, which are another class of antihypertensive medications that can slow down the heart rate.
Choice D is wrong because nifedipine does not cause hypoglycemia. Monitoring blood glucose levels for signs of hypoglycemia is more relevant for medications that lower blood sugar, such as insulin or oral antidiabetic agents.
Normal ranges for blood pressure and pulse rate during pregnancy are 110-140/60-90 mmHg and 60-100 beats per minute, respectively. Normal range for blood glucose level during pregnancy is 70-110 mg/dL.
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Correct Answer is D
Explanation
The correct answer is choice D) Level of consciousness and reflexes.This is because magnesium sulfate can cause toxicity and affect the central nervous system, leading to decreased level of consciousness and loss of reflexes.These are signs that the dose of magnesium sulfate should be reduced or stopped.
The nurse should prioritize assessing these parameters to prevent seizures and avoid magnesium toxicity.
Choice A) Respiratory rate and depth is wrong because magnesium sulfate can also cause respiratory depression, but this is a less common and less sensitive indicator of toxicity than level of consciousness and reflexes.
Choice B) Urine output and color is wrong because magnesium sulfate can also cause renal impairment, but this is not directly related to preventing seizures.However, urine output should be monitored to ensure adequate hydration and renal function.
Choice C) Blood pressure and heart rate is wrong because magnesium sulfate can also cause hypotension and bradycardia, but these are not the primary goals of therapy.Blood pressure and heart rate should be monitored to assess the severity of preeclampsia and the response to antihypertensive medications.
Correct Answer is C
Explanation
The correct answer is choice C) “I should report any dizziness or lightheadedness while taking this medication.” This is because labetalol can lower blood pressure and cause orthostatic hypotension, which can lead to falls and injuries.The patient should be advised to change positions slowly and monitor their blood pressure regularly while taking labetalol.
Choice A is wrong because labetalol can be taken with or without food.Taking it on an empty stomach does not affect its absorption or efficacy.
Choice B is wrong because labetalol does not affect potassium levels in the blood.Foods high in potassium are not contraindicated while taking this medication.
Choice D is wrong because swelling in the feet or hands can be a sign of worsening preeclampsia, which is a serious complication of hypertension in pregnancy.The patient should not stop taking labetalol without consulting their doctor, as this can cause rebound hypertension and endanger the mother and the fetus.The patient should seek medical attention if they experience swelling, headache, vision changes, abdominal pain, or reduced fetal movements.
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