A nurse is caring for a client who is at 28 weeks of gestation and has a blood pressure of 160/100 mm Hg.
The nurse should anticipate a prescription for which of the following medications?
Hydralazine
Nifedipine
Labetalol
Methyldopa
The Correct Answer is C
Labetalol is an antihypertensive drug that can lower blood pressure in pregnant women with preeclampsia. Preeclampsia is a condition that causes high blood pressure and proteinuria after 20 weeks of gestation.
Choice A is wrong because hydralazine is not recommended as a first-line treatment for preeclampsia due to its potential adverse effects on maternal and fetal outcomes.
Choice B is wrong because nifedipine is not licensed for use in pregnancy and may interact with magnesium sulfate, which is an anticonvulsant medication used to prevent or treat seizures in severe preeclampsia.
Choice D is wrong because methyldopa is not effective for acute blood pressure control and may cause adverse effects such as depression, sedation, and hemolytic anemia.
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Correct Answer is B
Explanation
The client will have to monitor her blood pressure at home for a month after delivery because preeclampsia can persist or develop for the first time after delivery.The client should seek medical care if she has signs of postpartum preeclampsia, such as severe headaches, vision changes, severe belly pain, nausea and vomiting.
Choice A is wrong because magnesium sulfate is an anticonvulsant medication that is given to prevent seizures in women with severe preeclampsia during labor and usually for 24 hours after delivery.
It is not needed for another week.
Choice C is wrong because breastfeeding is not contraindicated in women with preeclampsia.Breastfeeding may even lower the blood pressure and help with bonding.
Choice D is wrong because contraception is not related to preeclampsia.The client should discuss with her healthcare provider about the best contraceptive method for her based on her medical history and preferences.
Correct Answer is A
Explanation
The client has no seizures.Magnesium sulfate therapy is used to prevent seizures in women with preeclampsia and eclampsia.Seizures are a life-threatening complication of eclampsia and indicate a failure of therapy.
Choice B is wrong because diuresis is not a goal of magnesium sulfate therapy.Diuresis may indicate fluid overload or renal impairment, which are complications of preeclampsia and eclampsia.
Choice C is wrong because improved fetal movement is not a direct outcome of magnesium sulfate therapy.Fetal movement may be affected by many factors, such as gestational age, maternal position, and fetal well-being.
Choice D is wrong because increased platelet count is not a result of magnesium sulfate therapy.Platelet count may be decreased in preeclampsia and eclampsia due to disseminated intravascular coagulation, which is a serious complication that requires prompt treatment.
Normal ranges for blood pressure are less than 140/90 mm Hg, for proteinuria are less than 300 mg/24 hours, for platelet count are 150,000 to 400,000/mm3, and for serum magnesium are 1.5 to 2.5 mEq/L.
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