Independent nurse prescriber

Independent nurse prescriber

Case study
34 year old female,
Complaining of headaches which are not being controlled with paracetamol, and feeling dizzy for more than a week, she is currently 26 weeks pregnant.
Is found to have a very high blood pressure, which is what is concluded is causing these problems.
Patient was known to be Hypertensive before becoming pregnant and was on the ACE inhibitor enalapril, which she states worked well for her and she had no problems with. These were stopped when she got pregnant.
She is also a diabetic on metformin 1gm twice a day, and her blood sugars remain well controlled, and has had 1 previous pregnancy with no complication. Normally fit and well.
What medication would you prescribe safely for the high blood pressure instead of the enalapril and why
Does this have interaction with her metformin? May mask warning signs of low blood sugars, but not interact directly with the medication
Can she have any other pain relief other than paracetamol – yes codeine, but risks of constipation.

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