A nurse is evaluating the effectiveness of magnesium sulfate therapy for a client who is in pre-term labor.
Which of the following findings indicates that the therapy is successful?
The client reports decreased uterine contractions
The client’s blood pressure decreases to within normal limits
The client’s deep tendon reflexes are 2+
The client’s urine output increases to more than 30 mL/hr
The Correct Answer is A
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.
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Correct Answer is D
Explanation
According to the search results, magnesium sulfate can have a negative effect on the fetal heart rate (FHR) by lowering the baseline, decreasing the variability, and reducing the reactivity or acceleration pattern.Absent variability means that there is no fluctuation in the FHR and it indicates fetal hypoxia or acidosis.
This is a potential adverse effect of magnesium sulfate on the fetus and requires immediate intervention.
Choice A.Accelerations is wrong because accelerations are transient increases in the FHR that indicate fetal well-being.They are not affected by magnesium sulfate.
Choice B.Early decelerations is wrong because early decelerations are decreases in the FHR that occur with uterine contractions and are caused by fetal head compression.They are benign and do not indicate fetal distress.They are not associated with magnesium sulfate.
Choice C.Variable decelerations is wrong because variable decelerations are abrupt decreases in the FHR that vary in shape, duration, and timing and are caused by umbilical cord compression.
They may or may not indicate fetal compromise.
Correct Answer is A
Explanation
Nitrazine paper test.
This test involves putting a drop of fluid obtained from the vagina onto paper strips containing nitrazine dye.
The strips change color depending on the pH of the fluid.The strips will turn blue if the pH is greater than 6.0, which indicates the presence of amniotic fluid.This test can help confirm rupture of membranes (ROM) in pregnancy, especially when preterm labor is suspected.
Choice B. Ferning test.This test involves examining a sample of vaginal fluid under a microscope and looking for a fern-like pattern that is formed by dried amniotic fluid crystals.This test can also help confirm ROM, but it is less reliable than the nitrazine test because other substances such as cervical mucus, semen, or blood can also cause ferning.
Choice C. Amniotic fluid index.This test involves measuring the amount of amniotic fluid in the uterus using ultrasound.This test can help assess the fetal well-being and detect conditions such as oligohydramnios (low amniotic fluid) or polyhydramnios (high amniotic fluid).This test cannot confirm ROM by itself, but it can be used in combination with other tests to evaluate the status of the pregnancy.
Choice D. Biophysical profile.This test involves using ultrasound and a fetal monitor to assess the fetal heart rate, breathing, movement, muscle tone, and amniotic fluid volume.
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