85. A client, who is a 44-year-old gravida 2, para 1, is at 18 weeks' gestation with consistent blood pressures ranging from 130 to 140/80 to 90 mm Hg during her last two prenatal visits. She has no proteinuria or hyperreflexia. Which medication should a nurse anticipate being prescribed for this client?
Test-Taking Tip
This key to this question is that the client has chronic hypertension and is in the second trimester. Preeclampsia generally begins in the third trimester with proteinuria and hyperreflexia; this client has no proteinuria or hyperreflexia.
Content Area: Maternity, Antepartum, At-risk; Integrated Process: Nursing Process, Planning; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Pharmacological and Parenteral Therapies/Expected Effects/Outcomes
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Answer 1 is incorrect because Vasotec is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are not used in pregnancy due to the potential for certain fetal defects. Answer 2 is correct because this client is in the second trimester of pregnancy and has a history of high blood pressure during the pregnancy, an indicator of chronic hypertension. Aldomet is an antihypertensive drug that is safe during pregnancy, and is commonly used for chronic hypertension during pregnancy. Answer 3 is incorrect because diazepam is used to treat seizures in eclampsia. This client has chronic hypertension, not preeclampsia. Answer 4 is incorrect because magnesium sulfate is used to prevent seizures in eclampsia. This client has chronic hypertension, not preeclampsia, and magnesium is not an antihypertensive agent.
