A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient?
a. The fetus most likely will have serious congenital defects.
b. The fetus must be monitored closely while the patient is taking this drug.
c. The patient's prescriber probably will change her medication to an ARB.
d. The patient should stop taking the medication and contact her provider immediately.
ANS: D
ACE inhibitors are known to cause serious fetal injury during the second and third trimesters of pregnancy. Whether injury occurs earlier in pregnancy is unknown, and the incidence probably is low. However, women should be counseled to stop taking the drug if they become pregnant, and they should not take it if they are contemplating becoming pregnant. Women who take ACE inhibitors in the first trimester should be counseled that the risk to the fetus is probably low. Women should stop taking the drug when pregnant. ARBs carry the same risk as ACE inhibitors.
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