A nurse is caring for a client who has a diagnosis of HELLP syndrome.

The nurse should monitor the client for which of the following complications? (Select all that apply.)

The correct answer is d. Notify the health care provider.

Rationale for Choice A:

• Increasing the rate of oxytocin infusion is contraindicated in this situation.
• Oxytocin stimulates uterine contractions,and the client is already experiencing excessively frequent and prolonged contractions.
• Increased oxytocin could further compromise uteroplacental blood flow and exacerbate fetal distress.
• It could also put the client at higher risk for uterine rupture,a serious complication associated with oxytocin use.

Rationale for Choice B:

• While administering oxygen is a common intervention for fetal distress,it's not the priority action in this case.
• Late decelerations in fetal heart rate are typically caused by uteroplacental insufficiency,which means the fetus isn't receiving adequate oxygen and nutrients from the placenta.
• Oxygen administered to the mother may not significantly improve fetal oxygenation if the underlying issue is impaired placental perfusion.

Rationale for Choice C:

• Turning the client to her left side is a recommended position to improve placental blood flow.
• However,in this situation,it's not the priority action given the presence of late decelerations and excessive uterine contractions.
• It may be a helpful adjunct measure,but it won't address the primary cause of fetal distress.

Rationale for Choice D:

• Notifying the health care provider is the most crucial action because:
  • The client has severe pre-eclampsia,a serious condition that requires close monitoring and management.
  • The frequent and prolonged contractions,along with late decelerations in the fetal heart rate,indicate potential fetal distress.
  • The health care provider needs to be aware of these changes to make timely decisions regarding interventions,such as:
    • Adjusting the oxytocin infusion
    • Expediting delivery if necessary
    • Implementing other measures to improve fetal well-being
    • Closely monitoring the mother's condition to prevent complications of pre-eclampsia

Calcium gluconate is the antidote for magnesium sulfate toxicity because it reverses the effects of magnesium on the neuromuscular and cardiovascular systems.

Magnesium sulfate can cause respiratory depression, hypotension, bradycardia, and cardiac arrest in high doses.

Choice B. Naloxone is wrong because it is the antidote for opioid overdose, not magnesium sulfate toxicity.

Naloxone blocks the opioid receptors and restores breathing and consciousness.

Choice C. Flumazenil is wrong because it is the antidote for benzodiazepine overdose, not magnesium sulfate toxicity.

Flumazenil binds to the benzodiazepine receptors and reverses the sedative and hypnotic effects.

Choice D. Protamine sulfate is wrong because it is the antidote for heparin overdose, not magnesium sulfate toxicity.

Protamine sulfate neutralizes the anticoagulant effect of heparin and prevents bleeding.

Normal ranges for magnesium are 1.5 to 2.5 mEq/L or 0.75 to 1.25 mmol/L.