QUESTION: "Which of the following would the nurse expect to administer as the drug of choice to a pregnant client with chronic hypertension?"
CHOICES
( X ) a.) Phenobarbital.
( X ) b.) Diazepam (Valium).
( O ) c.) Methyldopa (Aldomet).
( X ) d.) Magnesium sulfate.
RATIONALE: Methyldopa (Aldomet) is the antihypertensive drug of choice for pregnant clients with chronic hypertension. The drug is given in the lowest possible dose. Long-term follow-up of children whose mothers took methyldopa indicates no signs of teratogenic effects. Phenobarbital is not used because of the risk for fetal respiratory depression. Diazepam is not used because of the risk for fetal respiratory depression. Magnesium sulfate is not usually prescribed for chronic hypertension. Rather it is used more commonly to treat pregnancy-induced hypertension. Approximately 15% of women with chronic hypertension develop superimposed pregnancy-induced hypertension. NURSING PROCESS STEP: Implementation CLIENT NEEDS CATEGORY: Physiological integrity CLIENT NEEDS SUBCATEGORY: Pharmacological and parenteral therapies
