MEDizzy - A nurse admits a client who is 28 weeks pregnant and

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Neonatal and High-Risk Neonatal Management

A nurse admits a client who is 28 weeks pregnant and experiencing congestive heart failure. When initiating a health-care provider’s admission orders for the client, which order should the nurse question?

ExplanationCaptopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are contraindicated in the second and third trimesters of pregnancy. They can cause oligohydramnios, intrauterine growth retardation (IUGR), congenital structural defects, and renal failure. Digoxin, furosemide, and metoprolol are all Category C medications, but they have not been shown to cause fetal harm. Digoxin exerts a positive inotropic action on the heart. Metoprolol, which is a beta blocker, can improve left ventricular ejection fraction and slow the progression of heart failure, and furosemide is a diuretic.