A nurse is monitoring a client with severe pre-eclampsia who is receiving magnesium sulfate intravenously.
Which of the following signs indicates magnesium toxicity and requires immediate intervention?
Loss of reflexes
Headache
Nausea
Blurred vision
The Correct Answer is A
According to Mayo Clinic, loss of reflexes is a sign of magnesium toxicity and requires immediate intervention.
Other signs of magnesium toxicity include:
• Decreased urine output
• Difficulty breathing
• Drowsiness or confusion
• Low blood pressure
• Slow heart rate
• Weakness
Choice B is wrong because headache is not a sign of magnesium toxicity.
It may be a symptom of preeclampsia or other conditions, but it does not indicate an overdose of magnesium sulfate.
Choice C is wrong because nausea is not a sign of magnesium toxicity.
It may be a side effect of magnesium sulfate or a symptom of preeclampsia or other conditions, but it does not indicate an overdose of magnesium sulfate.
Choice D is wrong because blurred vision is not a sign of magnesium toxicity.
It may be a symptom of preeclampsia or other conditions, but it does not indicate an overdose of magnesium sulfate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Elevated serum lactate dehydrogenase (LDH) indicates hemolysis, which is one of the components of HELLP syndrome.Hemolysis is the destruction of red blood cells that occurs when they pass through damaged blood vessels.
Choice A is wrong because elevated serum creatinine indicates kidney dysfunction, which is not specific for hemolysis.
Choice C is wrong because elevated serum alkaline phosphatase (ALP) indicates liver damage, which is another component of HELLP syndrome, but not specific for hemolysis.
Choice D is wrong because elevated serum uric acid indicates increased purine metabolism, which can be associated with preeclampsia and HELLP syndrome, but not specific for hemolysis.
Correct Answer is C
Explanation
C. Fetal heart rate decelerations.
Fetal heart rate decelerations are temporary drops in the fetal heart rate that can indicate fetal distress or lack of oxygen.There are three types of decelerations: early, late and variable.Early decelerations are benign and caused by compression of the fetus’s head during a uterine contraction.Late decelerations are caused by uteroplacental insufficiency, which is a decrease in blood flow to the placenta.Variable decelerations are the most common type and vary in shape, duration and intensity.They are often caused by cord compression or other factors that affect fetal oxygenation.
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A. Fetal heart rate of 140 beats per minute.
Statement is wrong because this is a normal fetal heart rate.The normal range for fetal heart rate is 120-160 beats per minute.
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B. Uterine contractions every 10 minutes.
Statement is wrong because this is a normal frequency for uterine contractions during early labor.
The normal range for uterine contractions is 5-10 minutes apart.
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D. Uterine contractions lasting 60 seconds.
Statement is wrong because this is a normal duration for uterine contractions during active labor.
The normal range for uterine contractions is 45-90 seconds long.
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