Drugs and it’s Indication

 Methyldopa is in a class of medications called antihypertensives. It works by relaxing

the blood vessels so that blood can flow more easily through the body. High blood
pressure is a common condition and when not treated, can cause damage to the brain,
heart, blood vessels, kidneys and other parts of the body.

 Labetalol is a drug used to treat high blood pressure. It's also known by its brand names
Normodyne and Trandate. This medicine is in a group of drugs called beta blockers. It
works by relaxing blood vessels and slowing heart rate to improve blood flow and
decrease blood pressure.

 Hydralazine is a vasodilator that works by relaxing the muscles in your blood vessels to
help them dilate (widen). This lowers blood pressure and allows blood to flow more
easily through your veins and arteries. Hydralazine is used to treat high blood pressure
(hypertension).

 Tenormin (Atenolol) is indicated for the treatment of hypertension, to lower blood

pressure. Lowering blood pressure lowers the risk of fatal and non-
fatal cardiovascular events, primarily strokes and myocardial infarctions. These benefits
have been seen in controlled trials of antihypertensive drugs from a wide variety of
pharmacologic classes including atenolol.

 Nifedipine is in a group of drugs called calcium channel blockers. It works by relaxing

the muscles of your heart and blood vessels. Nifedipine is used to treat hypertension
(high blood pressure) and angina (chest pain). 

Nursing Considerations

Nurses also have a role in reducing the blood pressure of the patient. These are just simple
interventions but could create a dramatic effect when applied properly.

 Promote bed rest in a recumbent position to aid in the secretion of sodium.

 Promote good nutrition, since the woman has still to continue her usual pregnancy
nutrition.
 Provide emotional support to establish a trusting relationship and let the woman voice out
her fears.
 Monitor blood pressure of the patient. Measure in both arms or thighs three times, 3-5
minutes apart while patient is at rest, then sitting, then standing for initial evaluation
 Observe skin color, moisture, temperature, and capillary refill
 Note and assess for edema
 Maintain activity restrictions
  Instruct relaxation techniques and guided imagery

Situational Questions
1. A 34-year-old patient was diagnosed having pregnancy induced hypertension. Which of
the following would the nurse identify as a classic sign of PIH?
a) Edema of the feet and ankles
b) Edema of the hands and face
c) Weight gain of 1 lb./week
d) Early morning headache

Rationale: Edema of the hands and face is a classic sign of PIH. Many healthy pregnant women
experiences foot and ankle edema. A weight gain of 2 lb. or more per week indicates a problem.
Early morning headache is not a classic sign of PIH.

2. A patient was admitted to the hospital diagnosed with pregnancy-induced hypertension.

As a nurse, you know that PIH probably exhibits which of the following symptoms?

a) Proteinuria, headaches, vaginal bleeding

b) Headaches, double vision, vaginal bleeding
c) Proteinuria, headaches, double vision
d) Proteinuria, double vision, uterine contractions

Rationale: A patient with pregnancy-induced hypertension complains of headache, double

vision, and sudden weight gain. A urine specimen reveals proteinuria. Vaginal bleeding and
uterine contractions are not associated with pregnancy-induced hypertension.

3. A client with severe preeclampsia is admitted with of BP 160/110, proteinuria, and

severe pitting edema. Which of the following would be most important to include
in the client’s plan of care?
a) Daily weights
b) Seizure precautions
c) Right lateral positioning
 d) Stress reduction
Rationale: Women hospitalized with severe preeclampsia need decreased CNS
stimulation to prevent a seizure. Seizure precautions provide environmental safety should
a seizure occur. Because of edema, daily weight is important but not the priority.
Preeclampsia causes vasospasm and therefore can reduce utero-placental perfusion. The
client should be placed on her left side to maximize blood flow, reduce blood pressure, and
promote diuresis. Interventions to reduce stress and anxiety are very important to facilitate
coping and a sense of control, but seizure precautions are the priority.

4. When administering magnesium sulfate to a client with preeclampsia, the nurse

understands that this drug is given to:
a) Prevent seizures
b) Reduce blood pressure
c) Slow the process of labor
d) Increase dieresis

Rationale: The chemical makeup of magnesium is similar to that of calcium and,

therefore, magnesium will act like calcium in the body. As a result, magnesium will block
seizure activity in a hyper stimulated neurologic system by interfering with signal
transmission at the neuromuscular junction.

5. When evaluating a client’s knowledge of symptoms to report during her

pregnancy, which statement would indicate to the nurse in charge that the client
understands the information given to her?
a) “I’ll report increased frequency of urination.”
b) “If I have blurred or double vision, I should call the clinic immediately.”
c) “If I feel tired after resting, I should report it immediately.”
d) “Nausea should be reported immediately.”
Rationale: Blurred or double vision may indicate hypertension or preeclampsia and
should be reported immediately. Urinary frequency is a common problem during
pregnancy caused by increased weight pressure on the bladder from the uterus. Clients
generally experience fatigue and nausea during pregnancy.