A nurse is preparing to administer an IV loading dose of magnesium sulfate to a client who has preeclampsia with severe features.

Which of the following actions should the nurse take?

The correct answer is choice D. Have calcium gluconate available at the bedside as an antidote.Magnesium sulfate is used to prevent and treat seizures in women with severe preeclampsia or eclampsia.However, it can also cause toxicity and respiratory depression if the serum level is too high.Calcium gluconate is the antidote for magnesium sulfate toxicity and should be readily available at the bedside.

Choice A is wrong because the medication should be administered over 20-30 minutes using an infusion pump.

A shorter infusion time may increase the risk of adverse effects.

Choice B is wrong because the client should be placed in a lateral position to improve uteroplacental perfusion and reduce the risk of aspiration.

Choice C is wrong because the client’s blood pressure should be monitored every 5 minutes during the infusion, not every 15 minutes.

Blood pressure is an indicator of the severity of preeclampsia and the effectiveness of magnesium sulfate therapy.

The correct answer is choice D. All of the above.All of these factors increase a woman’s risk for developing gestational hypertension.

Choice A is wrong because nulliparity (having no previous pregnancies) is a risk factor for gestational hypertension.Rates in nulliparous women range from 6% to 17% while rates in multiparous women range from 2% to 4%.

Choice B is wrong because age younger than 20 years is a risk factor for gestational hypertension.Pregnant women more than 40 years or less than 18 years are at risk of gestational hypertension.

Choice C is wrong because history of chronic renal disease is a risk factor for gestational hypertension.High blood pressure can also cause problems during and after delivery, such as preeclampsia, eclampsia, stroke, and placental abruption.

Gestational hypertension is blood pressure greater than or equal to 140/90 that begins during the latter half of pregnancy (typically after 20 weeks) and goes away after childbirth.It can put the mother and her baby at risk for problems during the pregnancy, such as preterm delivery and low birth weight.