A nurse is caring for a client who is at 30 weeks of gestation and receiving magnesium sulfate for preeclampsia. The nurse should recognize which of the following manifestations as an adverse reaction to the medication?
Hypertension
Hypoglycemia
Respiratory rate 16/min
Urine output 20 mL/hr
The Correct Answer is D
A) Hypertension is not typically an adverse reaction to magnesium sulfate; this medication is actually used to lower high blood pressure in preeclampsia.
B) Hypoglycemia is also not a common adverse reaction to magnesium sulfate. This medication does not typically affect blood sugar levels.
C) A respiratory rate of 16/min is within normal limits and is not indicative of an adverse reaction to magnesium sulfate, which can cause respiratory depression if it does affect breathing.
D) Urine output of 20 mL/hr is a concerning sign and can indicate nephrotoxicity or acute kidney injury, which are possible adverse reactions to magnesium sulfate, especially in the context of preeclampsia where kidney function must be closely monitored.
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Related Questions
Correct Answer is D
Explanation
After giving birth, a woman's body undergoes many changes, including changes in the size and shape of the vagina. It is essential to have the correct size of diaphragm to ensure its effectiveness.
Therefore, the nurse should instruct the client to have a provider refit her for a new diaphragm.
Option a is incorrect because the diaphragm should be cleaned with warm water and mild soap, not an oil- based vaginal lubricant.
Option b is incorrect because the diaphragm should be removed no sooner than 6 hours after intercourse but should not be left in place for more than 24 hours.
Option c is incorrect because oil-based vaginal lubricants can damage latex diaphragms, reducing their effectiveness as a contraceptive method. Water-based lubricants should be used instead.
Correct Answer is C
Explanation
Absent deep tendon reflexes are a sign of magnesium toxicity, which can occur with high levels of magnesium in the bloodstream. This can be a serious complication that requires immediate atention from the provider.
Option A, a decrease in frequency of contractions, is actually a desired effect of magnesium sulfate in the management of preterm labor. It is not a cause for concern.
Option B, a blood pressure reading of 150/100 mm Hg, is high, but it is not necessarily related to the administration of magnesium sulfate. However, it should still be reported to the provider for appropriate management.
Option D, a urinary output of 35 mL/hr, is below the normal range but it may still be within an acceptable range for a client receiving magnesium sulfate. The provider should be notified if urinary output continues to decrease or if it falls below a certain threshold.
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