A nurse is caring for a client who has an abdominal surgical incision and notes an evisceration. Which of the following actions should the nurse take?

Choice A rationale:

Give the client protamine if signs of magnesium sulfate toxicity occur. Protamine is not the antidote for magnesium sulfate toxicity. Calcium gluconate or calcium chloride is used to counteract the effects of magnesium sulfate toxicity by antagonizing the action of magnesium on the neuromuscular junction and the heart.

Choice B rationale:

Monitor the FHR via Doppler every 30 min. While fetal heart rate (FHR) monitoring is important during magnesium sulfate infusion due to the risk of fetal distress, using Doppler every 30 minutes may not provide continuous and accurate monitoring. Continuous electronic fetal monitoring is the standard of care in this situation.

Choice C rationale:

Restrict the client's total fluid intake to 250 mL/hr. Magnesium sulfate is excreted by the kidneys, so maintaining adequate urine output is crucial to prevent magnesium toxicity. Restricting fluid intake to 250 mL/hr would likely reduce urine output, leading to an increased risk of magnesium sulfate accumulation in the body, which could be harmful.

Choice D rationale:

Measure the client's urine output every hour. Monitoring urine output is essential during magnesium sulfate infusion as it helps assess renal function and magnesium excretion. Adequate urine output (at least 30 mL/hr) is necessary to prevent magnesium toxicity. Therefore, measuring the client's urine output every hour is a critical nursing intervention to ensure the safety of the client.

Choice A rationale:

Distributive justice refers to the fair distribution of resources, benefits, and burdens in society. Ensuring that a homeless client receives preventive medical care exemplifies distributive justice as it promotes equal access to healthcare resources for all individuals, regardless of their housing situation.

Choice B rationale:

Being honest with the parents of a child about the need to report suspected abuse is an example of veracity, which is the duty to tell the truth. While honesty is important, it does not directly relate to distributive justice.

Choice C rationale:

Accepting the decision of an older adult client to live alone in her home respects the client's autonomy and independence but does not specifically demonstrate distributive justice.

Choice D rationale:

Keeping a promise to visit with a housebound client is an example of fidelity, the duty to fulfill promises. While it is ethically important, it does not exemplify distributive justice, which pertains to fair resource allocation.