Final answer:
The nurse should administer both magnesium sulfate and nifedipine simultaneously as prescribed, as they collaboratively decrease blood pressure through vasodilation and decreased sodium reabsorption. Monitoring of renal function is essential, but evaluation would require physician orders.
Step-by-step explanation:
Magnesium Sulfate and Nifedipine in Gestational Hypertension
When a nurse observes that a pregnant patient with gestational hypertension is prescribed both magnesium sulfate and nifedipine, the appropriate action is to administer both medications simultaneously. Magnesium sulfate acts by promoting vascular relaxation through calcium antagonism, assisting in blood pressure control. Nifedipine, a calcium channel blocker, also decreases blood pressure by acting as a vasodilator and increasing the glomerular filtration rate. Furthermore, it helps decrease sodium reabsorption in the kidneys, which can reduce blood volume and lower blood pressure. There is no indication to obtain a prescription for a change of drug or to adjust the dose of nifedipine unless directed by a physician. The combined use of these drugs is beneficial in managing blood pressure during pregnancy.
Monitoring renal function is important in patients receiving these medications as both can affect kidney function and fluid balances. However, unless specified by the patient's condition or laboratory results, the nurse would not independently evaluate renal function tests without orders from a physician. It is critical for nurses to understand the pharmacological effects of drugs used to treat hypertension during pregnancy, to ensure safe and effective patient care while preventing potential adverse outcomes for both the mother and fetus.