A patient is 3 days post c-section delivery for eclampsia. The client is receiving hydralazine (Apresoline). Which of the following would indicate that the medication is effective?

The patient's blood pressure dropped from 160/120 to 130/90

The patient states that her headache is gone

The patient's postoperative weight has dropped from 155 to 144 pounds

The patient has had no seizures since delivery

Answer and Explanation

The Correct Answer is A

A. The patient's blood pressure dropped from 160/120 to 130/90. Hydralazine is an antihypertensive medication used to lower blood pressure in conditions such as eclampsia. A reduction in blood pressure indicates that the medication is achieving its intended effect of controlling hypertension, reducing the risk of complications like stroke or organ damage.

B. The patient states that her headache is gone. While headaches are a symptom of severe hypertension, their resolution does not directly confirm the effectiveness of hydralazine. Other factors, such as pain relief or improved postpartum recovery, could contribute to headache relief.

C. The patient's postoperative weight has dropped from 155 to 144 pounds. Postpartum weight loss is expected due to fluid shifts and loss of pregnancy-related fluids, but it is not a direct measure of hydralazine’s effectiveness. The medication does not act as a diuretic or weight-loss agent.

D. The patient has had no seizures since delivery. While hydralazine helps lower blood pressure, preventing seizures in eclamptic patients is primarily managed with magnesium sulfate, not hydralazine. The absence of seizures is important but does not indicate the specific effectiveness of this antihypertensive medication.

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Correct Answer is ["A","B","C"]

Explanation

A. Frequent monitoring of vital signs. A post-dural puncture headache (PDPH) can occur after epidural anesthesia due to leakage of cerebrospinal fluid (CSF). Monitoring vital signs, particularly blood pressure and heart rate, helps assess for hypotension, fluid balance, and overall neurological status.

B. Assisting with a blood patch procedure. An epidural blood patch is the most effective treatment for a severe post-dural puncture headache. This procedure involves injecting the patient’s own blood into the epidural space to seal the CSF leak and relieve symptoms. The nurse should prepare for the procedure and educate the patient about it.

C. Administration of oral analgesics. Oral analgesics, such as acetaminophen or ibuprofen, are used to relieve mild to moderate headache symptoms. However, they may not be fully effective for a severe PDPH and are often used as supportive therapy along with other interventions.

D. Keeping the head of bed elevated at all times. Lying flat, rather than elevating the head of the bed, is actually recommended to help reduce CSF leakage and alleviate headache symptoms. Keeping the head elevated may worsen the headache by increasing CSF pressure changes.

A. Call for a STAT magnesium level B. Do nothing, this is the expected action of magnesium C. Prepare to administer hydralazine D. Decrease or Discontinue the magnesium sulfate infusion

Correct Answer is D

Explanation

A. Call for a STAT magnesium level. While obtaining a magnesium level is important to confirm magnesium toxicity, the priority action is to stop or reduce the infusion immediately to prevent further toxicity and respiratory depression.

B. Do nothing, this is the expected action of magnesium. Absent deep tendon reflexes, lethargy, and respiratory depression (RR 9) are signs of magnesium toxicity, not expected therapeutic effects. Immediate intervention is necessary to prevent worsening respiratory and cardiac complications.

C. Prepare to administer hydralazine. Hydralazine is used to treat hypertension in preeclampsia, but this patient’s blood pressure is not critically high, and the primary concern is magnesium toxicity, not hypertension. Administering hydralazine would not address the immediate life-threatening issue.

D. Decrease or Discontinue the magnesium sulfate infusion. The first action in magnesium toxicity is to stop or reduce the infusion to prevent further accumulation. If symptoms worsen, calcium gluconate, the antidote for magnesium toxicity, may be administered to reverse its effects, especially if respiratory depression progresses.

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A patient is 3 days post c-section delivery for eclampsia. The client is receiving hydralazine (Apresoline). Which of the following would indicate that the medication is effective?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After delivering a healthy baby boy with epidural anesthesia, a woman on the after-birth unit complains of a severe headache. The nurse should anticipate which actions in the patient's plan of care? (Select all that apply.)

Correct Answer is ["A","B","C"]

Explanation

Correct Answer is D

Explanation

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