Medications

Magnesium Sulfate
Classification: Anticonvulsant
Mechanism of Action: Inhibits convulsion by acting at
the myoneural junction to prevent release of
acetylcholine and to decrease the motor and plate
potential. It inhibits the contraction of the uterus by
directly acting on the myometrial cells and enhancing
uterine blood flow.
Indications: Tx of Acute Hypomagnesemia, to control
hypertension, for the prevention and control of
convulsions in pre/eclampsia

Side Effects: diarrhea
Nursing Responsibilities:
Monitor pulse, BP, respirations, and ECG frequently. RR
should be at least 16/min before each dose.
Monitor neurologic status before and & through out
therapy. Patellar reflex should be tested before each
parenteral dose.
Monitor intake and output ratios. Urine output should
be maintained at a level at least 100 ml/ hour.
Monitor serum Mg levels and renal function
periodically.
Dexamethasone
Classification: corticosteroid
Mechanism of Action:
Indication: Short-term tx for high risk mothers before
delivery to prevent RDS in the newborn.
Mechanism of Action: Suppress inflammation and normal
immune response.
Side Effects: Infection, trouble sleeping, excess stomach
acid secretion, increased hunger
Nursing Responsibilities:
Give daily dose before 9 am to mimic normal peak
corticosteroid levels.
Assess for signs of adrenal insufficiency (hypotension,
weight loss, weakness, n/v, anorexia, lethargy,
confusion, restlessness).
Observe pt. for peripheral edema, steady wt. gain,
rales/ crackles or dyspnea.
Monitor serum electrolytes & glucose.
Advise pt. to avoid people w/ known contagious
diseases
Hydralazine
Classification: Cardiovascular agent, Antihypertensive
Mechanism of Action: Reduces BP mainly by direct
effects on vascular smooth muscles of arterial
resistance vessels, resulting in vasodilation.
Indications: Moderate to severe hypertension
Side Effects: Tachycardia, sodium retention
Nursing Responsibilities:
Monitor BP and PR
Monitor I&O
Monitor weight, check for edema, and report weight
gain.
Make position changes slowly
Instruct to avoid strenuous exercises and hazardous
activities.
Nicardipine
Classification: Antihypertension, Ca channel blocker
Mechanism of Action: Inhibits the transport of calcium
into myocardial and vascular smooth muscle cells,
resulting in inhibition of excitation-contraction coupling
and subsequent contraction. Systemic vasodilation
resulting in decreased BP.
Indications: Management of hypertension, angina
Side Effects: drowsiness, dizziness, peripheral edema
Nursing Responsibilities:
Monitor BP and PR
Monitor I&O and daily weight.
Assess for rash during therapy.
Instruct to avoid grapefruit/grapefruit juice during
therapy. Change position slowly. Avoid driving and other
activities requiring alertness.

Furosemide
Classification: Loop diuretic
Mechanism of Action: Inhibits the reabsorption of Na
and Cl from the loop of Henle and distal renal tubule.
Increases renal secretion of water, sodium, chloride,
magnesium, potassium, and calcium.
Indication: Edema due to heart failure, hepatic
impairment or renal disease. Hypertension.
Side Effects: dehydration, hypoca, hypochloremia,
hypokal, hypoMg, hypoNa, hypovolemia, metabloic
alkalosis.
Nursing Responsibilities:
Assess fluid status, monitor weight, I&O, edema, lung
sounds, skin turgor, and mucous membranes.
Monitor BP & PR