Ms. BD is a 33-year-old G2P1 female who has a history of chronic HTN. She was diagnosed with this in the interim since her first pregnancy, and she has been well controlled with Prinizide 12.5/20 PO BID. Her period, usually very regular, was 5 days late. She performed a home pregnancy test which was positive. She states she feel “OK” but is concerned about both her HTN and her developing fetus. She has no other medical problems, symptoms, or concerns.
Assessment: Physical examination is unremarkable. Her BP is 128/68 and her pulse is 74. Her urine human chorionic gonadotropin (HCG) is positive. Her potassium is 4.2, blood urea nitrogen (BUN) is 14, and creatinine is 0.6. Alanine aminotransferase (ALT) is 29. White blood cells (WBCs) are 6.5, hemoglobin (Hgb) is 12.8, hematocrit (Hct) is 39, and platelets are 330,000.
1.Is there any additional subjective or objective information you need for this client? Explain.
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2.Is Prinizide safe in pregnancy? What are the possible complications to the pregnant woman and her fetus?
3.Why is it important to assess the above laboratory values? How might this information impact your treatment plan?
4.Would you make any changes to Ms. BD’s blood pressure medications? Explain. If yes, what would you prescribe? Discuss the medications safety in pregnancy, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.
5.What health maintenance or preventive education is important for this client based on your choice medication/treatment?
6.Would you treat this patient or refer her? Where would you refer this patient?
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