A nurse is evaluating the fetal status of a client who has preeclampsia and is receiving magnesium sulfate.
Which of the following findings should the nurse report to the provider as a sign of fetal compromise?
Fetal heart rate of 140 beats/min
Fetal movement of 10 times in an hour
Oligohydramnios on ultrasound
Reactive nonstress test
The Correct Answer is C
Oligohydramnios on ultrasound. Oligohydramnios is a condition where the amniotic fluid volume is less than expected for gestational age. It can be a sign of fetal compromise due to various causes, such as renal abnormalities, placental insufficiency, premature rupture of membranes, or chromosomal anomalies. Oligohydramnios can lead to complications such as fetal deformities, preterm birth, infection, or stillbirth.
Choice A is wrong because a fetal heart rate of 140 beats/min is within the normal range for most of pregnancy.
Choice B is wrong because fetal movement of 10 times in an hour is also within the normal range and indicates fetal well-being.
Choice D is wrong because a reactive nonstress test is a reassuring sign that the fetus is not hypoxic or stressed.
Normal ranges:
• Amniotic fluid index (AFI): 5-25 cm
• Fetal heart rate: 110-160 beats/min
• Fetal movement: at least 10 movements in 2 hours
• Nonstress test: at least two accelerations of fetal heart rate of 15 beats/min for 15 seconds or more in 20 minutes
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D","E"]
Explanation
The correct answer is choice A, C, D and E. Here is why:
• Choice A is correct becausedisseminated intravascular coagulation (DIC)is a blood clotting disorder that can develop as a complication of HELLP syndrome.DIC can result in excessive bleeding or blood clots in various organs.
• Choice B is wrong becauseacute kidney injuryis not a common complication of HELLP syndrome.However, preeclampsia can cause kidney damage and proteinuria (high levels of protein in the urine).
• Choice C is correct becausepulmonary edemais a condition where fluid accumulates in and around the lungs, impairing oxygen absorption.It can occur as a complication of HELLP syndrome due to high blood pressure and fluid overload.
• Choice D is correct becauseplacental abruptionis a condition where the placenta separates from the uterus before delivery.
It can cause severe bleeding and fetal distress.It can occur as a complication of HELLP syndrome due to high blood pressure and abnormal blood clotting.
• Choice E is correct becausefetal growth restrictionis a condition where the fetus does not grow as expected.It can occur as a complication of HELLP syndrome due to reduced blood flow and oxygen delivery to the placenta.
Normal ranges for liver enzymes are:
• Alanine aminotransferase (ALT): 7 to 55 units per liter (U/L)
• Aspartate aminotransferase (AST): 8 to 48 U/L
• Alkaline phosphatase (ALP): 45 to 115 U/L
Normal range for platelet count is:
• 150,000 to 450,000 platelets per microlitre.
Correct Answer is C
Explanation
Calcium gluconate is the antidote for magnesium sulfate overdose.Magnesium sulfate blocks calcium, so calcium gluconate can reverse the effect of an overdose.
The other choices are not antidotes for magnesium sulfate.Choice A, naloxone, is the antidote for narcotics or opioid overdose.Choice B, flumazenil, is the antidote for benzodiazepine overdose.Choice D, protamine sulfate, is the antidote for heparin overdose.The normal range of magnesium level is 1.5 to 2.5 mEq/L, so a level of 10 mg/dL indicates toxicity.
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