Pharmacotherapeutics for advanced practice nurse prescribers 6th edition Attached is a short case study supplied by the publishers of my textbook. Be sure to include written prescription

Woo, Pharmacotherapeutics for APN Prescribers, 4e Instructor Case Study-40-1

Chapter 40 Hypertension Instructor Case Study

Nancy is a chronic hypertensive patient who has been seen at your clinic for 5 years. She is happy today when she reports that she is 2 months pregnant and would like a referral to a nurse midwife for prenatal care. She has never had issues with her blood pressure after she quickly adapted to a calcium channel blocker and diuretic for her treatment. She does get a bit of dependent edema at the end of the day that remains less than 1+ and typically “gives me an excuse to put my feet up!” She comes with a sheaf of printouts about pre-eclampsia from the Internet. She is asking for a urine sample to check for protein because she “does not want a C- section.”

1. Would Nancy fit the mold for referral to a midwife for routine pregnancy care? Consider your nurse practice act for degree of complexity handled by certified nurse midwives in your state.

2. Is she correct in her assumption that she has pre-eclampsia? Compare and contrast the presentation of pregnancy-related edema and the side effects of calcium channel blockers (SE of CCBs).

3. Is she currently on any medications that must be stopped today before she sees an obstetrician/gynecologist? Review how prescribers can find information on pregnancy categories.

4. What are the categories of hypertension (HTN) medications typically given to women with pre-existing HTN who become pregnant? There are both classic medications and newer therapies to consider.

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