A nurse is caring for a client who is receiving magnesium sulfate for pre-term labor.

Which of the following assessments should the nurse perform to evaluate the therapeutic effect of the medication?

The client should not limit their physical activity and rest as much as possible, unless advised by their provider.Excessive rest and inactivity can increase the risk of blood clots and decrease blood circulation, which can affect the placenta and the fetus.The client should follow the recommended guidelines for physical activity during pregnancy, unless they have a medical condition that requires bed rest or reduced activity.

Choice A is wrong because smoking and drinking alcohol during pregnancy are known risk factors for preterm labor and birth.Smoking can reduce blood flow to the placenta and affect fetal growth and development, while alcohol can cause fetal alcohol spectrum disorders and other complications.

Choice B is wrong because reporting any vaginal bleeding or fluid leakage to the provider is important to prevent or treat preterm labor and birth.Bleeding can indicate placenta previa or placental abruption, which are serious conditions that can cause premature delivery or fetal distress.Fluid leakage can indicate rupture of membranes, which can increase the risk of infection and preterm labor.

Choice D is wrong because drinking plenty of fluids and eating a balanced diet are beneficial for the health of the mother and the fetus.Dehydration can cause uterine contractions and trigger preterm labor, while malnutrition can affect fetal growth and development.A balanced diet can also help prevent or manage conditions like diabetes, high blood pressure, and anemia, which are risk factors for preterm labor and birth.

Magnesium sulfate is a tocolytic drug that inhibits uterine activity and relaxes smooth muscles.The goal of magnesium sulfate therapy for a client who is in pre-term labor is to stop or reduce the frequency and intensity of contractions.

Choice B is wrong because the client’s blood pressure decreases to within normal limits.

Magnesium sulfate is not an antihypertensive drug and does not lower blood pressure.It is used to prevent seizures in clients with preeclampsia or eclampsia.

Choice C is wrong because the client’s deep tendon reflexes are 2+.

This is a normal finding and does not indicate the effectiveness of magnesium sulfate therapy.A decrease or loss of deep tendon reflexes may indicate magnesium toxicity, which is a serious complication that requires immediate intervention.

Choice D is wrong because the client’s urine output increases to more than 30 mL/hr.

This is also a normal finding and does not indicate the effectiveness of magnesium sulfate therapy.A decrease in urine output may indicate renal impairment or magnesium toxicity, which are both adverse effects of the drug.

The normal range for serum magnesium level is 1.5 to 2.5 mEq/L or 1.8 to 3 mg/dL.The therapeutic range for magnesium sulfate management is 5 to 8 mg/dL.