A nurse is collecting data from a client who is receiving magnesium sulfate via continuous IV infusion to treat preeclampsia. Which of the following findings indicates that the medication is having a therapeutic effect?

Positive clonus

Urinary output 20 mL/hr

Respiratory rate 10/min

Deep tendon reflexes 2+

Answer and Explanation

The Correct Answer is D

A. Positive clonus is a sign of hyperreflexia and can indicate worsening preeclampsia or severe central nervous system irritability. It is not a therapeutic effect of magnesium sulfate.

B. Urinary output 20 mL/hr is below the minimum expected urine output (which is generally 30 mL/hr). This finding suggests oliguria and may be a sign of worsening renal function, which is not a therapeutic effect of magnesium sulfate.

C. Respiratory rate 10/min is too low. Magnesium sulfate can cause respiratory depression, and a respiratory rate of 10/min may indicate toxicity. This is not a therapeutic effect.

D. Deep tendon reflexes 2+ is the correct answer. Magnesium sulfate is used to prevent seizures in preeclampsia by acting as a CNS depressant. A normal response of 2+ for deep tendon reflexes indicates that magnesium sulfate is having a therapeutic effect and the client is not experiencing magnesium toxicity (which would typically cause a decreased reflex response..

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Correct Answer is A

Explanation

A. "A client who has a sodium level of 140 mEq/L after one episode of diarrhea." This is the correct choice. A sodium level of 140 mEq/L is within the normal range, and the client has had only one episode of diarrhea, suggesting that they are stable and could be safely discharged.

B. "A client who is 3 days postoperative following a hip arthroplasty and has a warm, red area on his left calf." This is a concern. The warm, red area on the calf could indicate the presence of a deep vein thrombosis (DVT) or infection, both of which require further evaluation and management.

C. "A client who has atrial fibrillation and an INR of 4." This is concerning. An INR of 4 indicates an increased risk of bleeding, which requires closer monitoring and potentially adjusting the anticoagulation therapy before discharge.

D. "A client who reports chest pain after ambulating." This is an urgent issue that needs immediate attention. Chest pain could indicate a serious cardiac event, such as a myocardial infarction, and the client should not be discharged until further evaluation is performed.

A. Reduced fat in the stools B. Decreased sodium excretion C. Improved respiratory function D. Improved absorption of vitamins B and C

Correct Answer is A

Explanation

A. Reduced fat in the stools is correct. Pancrelipase is an enzyme replacement therapy that helps improve digestion and absorption of fats and proteins in individuals with cystic fibrosis. This treatment is especially important for those with pancreatic insufficiency, as it helps prevent the steatorrhea (fatty stools) commonly seen in these patients.

B. Decreased sodium excretion is incorrect. Pancrelipase does not directly affect sodium balance in the body. Cystic fibrosis patients may experience increased sodium excretion, which requires special management of fluid and electrolytes.

C. Improved respiratory function is incorrect. While pancrelipase improves digestion, it does not directly affect respiratory function, which is primarily impacted by the progressive lung disease in cystic fibrosis.

D. Improved absorption of vitamins B and C is incorrect. While pancrelipase helps with fat absorption, it primarily improves the absorption of fat-soluble vitamins (A, D, E, K) rather than water-soluble vitamins like B and C.

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