A nurse is assessing a client who is receiving magnesium sulfate to treat pre-eclampsia.
Which of the following findings should the nurse report to the provider?

Rationale:

A. Asking a psychiatrist to talk with the parents may not be the most appropriate immediate

action when abuse is suspected. Reporting to the authorities should take precedence to ensure the child's safety.

B. Obtaining a detailed history is important but should be done after reporting the suspected abuse to the authorities.

C. Separating the child from the parents may not be feasible or appropriate in all situations.

Reporting to the authorities is the priority action to ensure proper investigation and protection of the child.

D. Report the suspected abuse to the authorities. Suspected child abuse must be reported

immediately to the appropriate authorities, such as child protective services or law enforcement, for further investigation and intervention to ensure the safety and well-being of the child.

Rationale:

A. Obtain a type and crossmatch: While obtaining a type and crossmatch may be necessary in the event of significant hemorrhage, the first action should be to address the potential cause of hypotension, which could be uterine atony.

B. Evaluate the firmness of the uterus: Postpartum hypotension is often caused by uterine atony, so the first action should be to assess the firmness of the uterus and massage it to stimulate contraction if necessary.

C. Administer oxytocin infusion: Oxytocin infusion may be necessary to help contract the uterus and control bleeding, but it should be implemented after assessing uterine firmness.

D. Initiate oxygen therapy by nonrebreather mask: While oxygen therapy may be needed if the client is hypotensive due to hemorrhage, assessing uterine firmness is the priority action to address the potential cause of hypotension.