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Author Question: A patient takes an ACE inhibitor to treat hypertension and tells the nurse that she wants to become ... (Read 107 times)

dakota nelson

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on: Jul 23, 2018
A patient takes an ACE inhibitor to treat hypertension and tells the nurse that she wants to become pregnant. She asks whether she should continue taking the medication while she is pregnant. What will the nurse tell her?
 
  a. Controlling her blood pressure will de-crease her risk of preeclampsia.
  b. Ask the provider about changing to an ARB during pregnancy.
  c. Continue taking the ACE inhibitor during her pregnancy.
  d. Discuss using methyldopa instead while she is pregnant.

Question 2

A 14-year-old male patient has not begun puberty. His parents tell the nurse that their son does not want to go to school, because he gets teased. The nurse learns that the boy's father did not begin puberty until age 16 years.
 
  Laboratory tests on this child do not reveal true hypogonadism. What will the nurse tell these parents when they ask what can be done for their son? a. A limited course of androgen therapy may be prescribed, but it is not necessary.
  b. He will eventually begin puberty, so this is nothing to worry about.
  c. He will probably have to receive injec-tions of androgens for 3 to 4 years.
  d. The risk of accelerated growth plate clo-sure is too great to warrant androgen therapy.


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softEldritch

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Reply #1 on: Jul 23, 2018
Answer to Question 1

D
Methyldopa has limited effects on uteroplacental and fetal hemodynamics and does not adversely affect the fetus or neonate. Controlling blood pressure does not lower the risk of preeclampsia. ACE inhibitors and ARBs are specifically contraindicated during pregnancy.

Answer to Question 2

A
Although treatment is not required in this patient, the psychologic effects of delayed puberty in-dicate a limited course of androgen therapy. Telling the parents not to worry does not address their concerns. This patient will not be a candidate for long-term androgen replacement therapy. Limited treatment can minimize the risk of epiphyseal closure, especially with close monitoring and radiographs.


dakota nelson

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Reply #2 on: Jul 23, 2018
Both answers were spot on, thank you once again


softEldritch

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Reply #3 on: Jul 23, 2018
Great! Please up vote :D


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