A client who is 36 weeks pregnant is admitted to the hospital with a diagnosis of eclampsia.
She has a history of chronic hypertension and gestational diabetes.
The nurse anticipates that the client will receive which of the following medications to prevent seizures?
Hydralazine
Nifedipine
Magnesium sulfate
Diazepam
The Correct Answer is C
Magnesium sulfate. Magnesium sulfate is the drug of choice to prevent and treat seizures in people with severe preeclampsia and eclampsia. It is an anticonvulsant medication that reduces the risk of eclampsia by 50%.
Choice A is wrong because hydralazine is a blood pressure medication that can lower blood pressure in people with preeclampsia or eclampsia, but it does not prevent seizures.
Choice B is wrong because nifedipine is another blood pressure medication that can lower blood pressure in people with preeclampsia or eclampsia, but it does not prevent seizures.
Choice D is wrong because diazepam is an anticonvulsant medication that was previously used to treat eclamptic seizures, but it has been replaced by magnesium sulfate as the preferred drug due to its better safety and efficacy. Diazepam can also cause sedation and respiratory depression in the mother and the fetus.
Normal ranges for blood pressure are below 140/90 mm Hg, for proteinuria are below 300 mg/24 hours, for platelet count are 150,000 to 450,000 per microliter, for liver enzymes are 7 to 56 units per liter for alanine aminotransferase (ALT) and 10 to 40 units per liter for aspartate aminotransferase (AST), and for magnesium levels are 1.5 to 2.5 mEq/L.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Urinary output of 25 mL/hour.This indicates magnesium toxicity and requires immediate intervention because it means the kidneys are not functioning properly and magnesium is not being excreted.Magnesium toxicity can cause life-threatening complications such as respiratory depression, cardiac arrest, and coma.
B. Respiratory rate of 14 breaths/minute is normal and does not indicate magnesium toxicity.A respiratory rate of less than 12 breaths/minute or more than 20 breaths/minute would be abnormal and require further assessment.
C. Deep tendon reflexes 1+ are normal and do not indicate magnesium toxicity.A loss of deep tendon reflexes or clonus would indicate magnesium toxicity and require immediate intervention.
D. Serum magnesium level of 6 mg/dL is within the therapeutic range for preeclampsia and does not indicate magnesium toxicity.
The therapeutic range for preeclampsia is 4 to 7 mg/dL.A serum magnesium level of more than 8 mg/dL would indicate magnesium toxicity and require immediate intervention.
Correct Answer is A
Explanation
This indicates a therapeutic level of magnesium sulfate for a client with severe pre-eclampsia who is receiving magnesium sulfate.According to some sources, the effective therapeutic serum magnesium level is 1.8–3.0 mmol/L, which corresponds to 4.2–7 mg/dL or 3.5–7 mEq/L.
Choice B is wrong because serum calcium level of 8.5 mg/dL is within the normal range and does not indicate the effect of magnesium sulfate.
Choice C is wrong because serum creatinine level of 1.2 mg/dL is within the normal range and does not indicate the effect of magnesium sulfate.
Choice D is wrong because serum potassium level of 3.5 mEq/L is at the lower end of the normal range and does not indicate the effect of magnesium sulfate.
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