A nurse is assessing a client who received magnesium sulfate to treat preterm labor. Which of the following clinical findings should the nurse identify as an indication of toxicity of magnesium sulfate therapy and report to the provider?

Explanation:

A. Preeclampsia: Preeclampsia is a condition characterized by high blood pressure and signs of damage to other organs, typically occurring after 20 weeks of pregnancy. While preeclampsia is a concern during pregnancy, it is not directly related to abruptio placentae or the development of DIC.

B. Puerperal infection: Puerperal infection refers to an infection that occurs after childbirth. Although infections are a concern in the postpartum period, they are not specifically associated with abruptio placentae or the development of DIC unless there are additional risk factors or complications.

C. Anaphylactoid syndrome of pregnancy: Anaphylactoid syndrome of pregnancy (also known as amniotic fluid embolism) is a rare but serious condition where amniotic fluid enters the maternal circulation, potentially causing a severe allergic-like reaction. This condition is not directly related to abruptio placentae or the development of DIC.

D. Disseminated intravascular coagulation (DIC): This is the correct answer. DIC is a serious condition where the body's clotting mechanisms are abnormally activated, leading to widespread clot formation in small blood vessels. It can result from various conditions, including abruptio placentae, especially when there is evidence of bleeding such as petechiae and bleeding around the IV access site. DIC can lead to both bleeding tendencies and clot formation, affecting multiple organs and potentially causing severe complications.

Explanation:

A. Pattern of contractions: While the pattern of contractions is important in assessing labor progress, it alone may not differentiate between true labor and false labor (also known as Braxton Hicks contractions). True labor contractions typically become longer, stronger, and more frequent over time, but other factors must also be considered to confirm true labor.

B. Rupture of the membranes: Rupture of the membranes (water breaking) can occur during both true labor and false labor. However, it is not a definitive sign of true labor on its own, as it can also happen spontaneously or due to other reasons.

C. Changes in the cervix: This is the correct answer. True labor is characterized by progressive changes in the cervix, including effacement (thinning) and dilation (opening). These changes can be confirmed through a cervical examination performed by a healthcare provider.

D. Station of the presenting part: The station of the presenting part refers to the position of the baby's head in relation to the mother's pelvis. While the station can provide information about the progress of labor, it is not a specific sign of true labor by itself.