Medical Management for preeclampsia - Pharmacology

Name of Drug Use Indication/ Contraindication Side effects Nursing responsibilities

Dosage

Hydralazine is used to Essential Check if the client takes the

Hydralazine treat high blood hypertension, alone medication and if it is in the right
(Apresoline) pressure. It works by or as an adjunct.
Hypersensitivity to • flushing (feeling of
patient and check also the
hydralazine; warmth)
relaxing the blood Management of coronary artery doctor’s order. Observe for any
vessels so that blood moderate to severe • headache reaction to the medication like
disease; mitral
can flow more easily hypertension, valvular rheumatic headache, flushing, vomiting,
through the body. congestive heart heart disease. • eye tearing etc. If any reaction occurs
failure, inform your physician.
hypertension
secondary to pre- Monitor BP every 5 mins.
eclampsia/eclampsi
a; treatment of
primary pulmonary
hypertension.
Under indications.

Start with 10 mg
four times daily for
the first 2 to 4 days,
increase to 25 mg
four times daily for
the balance of the
first week. For the
second and
subsequent weeks,
increase dosage to
50 mg four times
daily. For
maintenance,
adjust dosage to
the lowest effective
levels.
Name of Drug Use Indication/ Contraindication Side effects Nursing responsibilities
Dosage

Arthrotec Used for treatmentfor ARTHROTEC is ARTHROTEC is • .abdominal pain Check if the client takes the
(Diclofenac Na) rheumatoid, indicated for contraindicated in • diarrhea medication. Check for the
arthritis,dysmenorrhe treatment of the patients with doctor’s order and if it is the
• GI symptoms
al, headache, post signs and hypersensitivity to right patient. Observe for
partum pain. symptoms of diclofenac or to any effect and if any side
Arthrotec contains osteoarthritis or misoprostol or effects occur inform
dicoflenac sodium rheumatoid other physician.
and misoprostol. arthritis in prostaglandins.
Administration of patients at high Carefully consider the
misoprotol to women risk of developing potential benefits and risks
who are pregnant NSAID-induced of ARTHROTEC and other
can cause abortion, gastric and treatment options before
premature birth , or duodenal ulcers deciding to use
birth defects. Uterine and their ARTHROTEC. Use the
rupture has been complications. lowest effective dose for the
reported when shortest duration consistent
misoprostol was with individual patient
asministered in ARTHROTEC is treatment ...
pregnant women to administered as
induce labor or to ARTHROTEC 50
induce abortion (50 mg diclofenac
beyond the 8th week
sodium/200 mcg
of pregnancy.
misoprostol) or
as ARTHROTEC
75 (75 mg
diclofenac
sodium/200 mcg
misoprostol).
Name of Drug Use Indication/ Contraindicatio Side effects Nursing responsibiliries
Dosage n

Before you administer

Penicillin G Penicillin G is used The early use of A previous • rash penicillin, look at the
routinely for penicillin G was hypersensitivity • fever solution closely. It should
maternal infections reaction to any • dizziness be clear and free of
linked to
during pregnancy. penicillin is a floating material. Gently
increased
contraindication. squeeze the bag or
uterine activity observe the solution
and abortion. It container to make sure
is not known there are no leaks. Do not
whether this use the solution if it is
was related to discolored, if it contains
impurities in the particles, or if the bag or
drug or to container leaks. Use a
new solution, but show
penicillin itself.
the damaged one to your
health care provider.
 IVFs, BT, NGT feeding, Nebulization, TPN, Oxygen Therapy

Medical Date Ordered General Indication & Purpose Client Response

Management Description to Treatment

IVF Date Ordered 5% dextrose in D5NM is The patient

November 15, 2008 lactated ringers administered by responded well

D5LRS 1L
solution intravenous infusion with no signs of
30gtts/min Date d/c November
(Osmolarity of for parenteral
irritation and
20, 2008
527-hyprtonic, maintenance of
adverse reactions.
pH of 4.9) routine daily fluid

-provides calories and electrolyte

and free water, requirement with

provides minimal

electrolytes. Also carbohydrates

contains sodium calories and to

lactate which is correct or replace

used in treating fluid losses due to

mild to moderate change in the

metabolic patient’s diet (NPO)

acidosis. and during the

cesarean operation.

Nursing Responsibilities:

• Check the doctor’s order

• Explain the procedure to the patient

• Tell the patient that she might feel a discomfort from the tourniquet and the IV

insertion

• Check and monitor IVF regulation and level of fluid

• Check if there is a need for removal and replacement of fluid

• Check if the tube is in the vein and signs of edema

• Check if there is a back-flow of blood

• Check if there is bubbles present in the tube

• Always Monitor V/S.

. Diagnostic Procedures

Common laboratory tests to diagnose Pregnancy-induced hypertension would include

blood test, renal function, creatinine, and BUN. But these tests were not noted on the client’s
chart. What we found out instead is the continual rising of the client’s blood pressure from the
time she got in the hospital at 10am until she was admitted.

Blood pressure taking is one easy method to monitor the client’s blood pressure. The
client’s blood pressure was at 170/90 at 10am then increased to 170/100 at 12nn and reached
190/100 at 1pm. While the normal blood pressure is below 120/80; blood pressure between
120/80 and 139/89 is called "pre–hypertension", and a blood pressure of 140/90 or above is
considered high.