A nurse is caring for a client who is taking multiple medications. Which of the following medications should the nurse identify as a controlled substance?

Rationale:

A. Administer a continuous infusion of calcium gluconate: Calcium gluconate is not used for the management of preeclampsia or seizure prophylaxis. Magnesium sulfate is the medication of choice to prevent eclamptic seizures in clients with severe preeclampsia.

B. Place the client in the semi-Fowler's position: Semi-Fowler’s position does not optimize uteroplacental perfusion. Left lateral positioning is preferred to enhance blood flow to the uterus and improve maternal and fetal oxygenation.

C. Ensure bright lighting in the room: Bright lighting can increase stimulation and anxiety, which is not beneficial for a client at risk for seizures. A calm, low-stimulation environment is preferable to minimize seizure triggers.

D. Initiate seizure precautions: Clients with preeclampsia with severe features are at high risk for eclampsia, making seizure precautions essential. These include placing the bed in a low position, padding side rails, having oxygen and suction available, and monitoring closely for neurologic changes.

Rationale:

A. Anemia: While anemia affects oxygen delivery and overall health, it is not a direct risk factor for neonatal hypoglycemia. Anemia does not significantly impact the infant’s glucose regulation immediately after birth.

B. Prematurity: Premature infants have limited glycogen stores, immature liver function, and underdeveloped metabolic pathways, making them more prone to hypoglycemia. Their ability to maintain normal blood glucose levels is compromised, increasing the risk of low glucose after birth.

C. Maternal diabetes: Infants born to mothers with diabetes are exposed to high glucose levels in utero, which stimulates fetal insulin production. After birth, this hyperinsulinemia can lead to rapid drops in blood glucose, placing the newborn at high risk for hypoglycemia.

D. Thrombocytopenia: Low platelet count affects coagulation but does not directly influence glucose metabolism or the risk of hypoglycemia in newborns. While it is a clinical concern, it is unrelated to neonatal glucose regulation.

E. Hypothermia: Cold stress increases metabolic demands and glucose utilization in newborns. Hypothermia can accelerate depletion of glycogen stores and impair gluconeogenesis, making it a significant risk factor for hypoglycemia in the neonatal period.