A prescriber has ordered methyldopa for a female patient with hypertension. The nurse understands that which laboratory tests are important before beginning therapy with this drug? (Select all that apply.)
a. Coombs' test
b. Hemoglobin and hematocrit (H&H)
c. Liver function tests
d. Pregnancy test
e. Urinalysis
A, B, C
A positive Coombs' test result occurs in 10% to 20% of patients who take methyldopa chroni-cally. A few of these patients (5%) develop hemolytic anemia. Blood should be drawn for a Coombs' test and an H&H before treatment is started and at intervals during treatment. Because methyldopa is associated with liver disorders, liver function tests should be performed before therapy is started and periodically during treatment. Clonidine, not methyldopa, is contraindi-cated during pregnancy. A urinalysis is not indicated.
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