A nurse is assisting with the care of a client who has a prescription for magnesium sulfate.Which of the following adverse effects should the nurse report to the provider?

1. Wrap a warm, moist cloth around the heel.
2. Cleanse the heel with an antiseptic.
3. Puncture the heel and collect the blood.
4. Apply pressure with a dry gauze pad.
5. Cover the heel with an adhesive bandage. .

An ectopic pregnancy is most likely due to the combination of symptoms: dizziness, pale skin, cool extremities, low blood pressure (86/48 mm Hg), and high heart rate (120/min). The soft and non-tender abdomen with no palpable contractions also suggests an ectopic pregnancy rather than other conditions. The low hematocrit (25%) and hemoglobin (9 g/dL) indicate significant blood loss, a hallmark of ectopic pregnancy.

Administer methotrexate is important to stop the growth of the embryo in an ectopic pregnancy. Insert a large-bore peripheral IV catheter to manage blood loss and prepare for potential surgery.

Monitoring beta human chorionic gonadotropin (hCG) levels is crucial to confirm the diagnosis and monitor treatment response. Platelet count should be monitored due to the risk of bleeding associated with an ectopic pregnancy.

Placenta previa usually presents with painless vaginal bleeding, which is absent in this case. Chorioamnionitis is typically associated with infection signs like fever, uterine tenderness, and elevated white blood cell count, not primarily dizziness and low blood pressure. Cervical insufficiency usually presents with painless cervical dilation, leading to preterm birth, not the acute signs seen here. Vaginal bleeding is a symptom, not a diagnosis, and this client reports no vaginal bleeding.