A nurse is reinforcing teaching with a client who is pregnant and whose routine diagnostic testing reveals a negative rubella titer.
Which of the following statements should the nurse tell the client?

A nurse is admitting a client who is at 36 weeks gestation and has painless, bright red vaginal bleeding. The nurse recognizes this finding as an indication of which of the following conditions? The correct answer is choice B: Placenta previa.

Choice A rationale:

"Abruptio placentae.”. This choice is incorrect. Abruptio placentae is characterized by the premature separation of the placenta from the uterine wall, which can result in painful and dark red vaginal bleeding. It is associated with abdominal pain and fetal distress. In this case, the bleeding is described as painless and bright red, which is more indicative of placenta previa.

Choice C rationale:

"Preterm labor.”. This choice is incorrect. Preterm labor involves regular uterine contractions that result in cervical changes before 37 weeks of gestation. Painless, bright red vaginal bleeding is not typically associated with preterm labor. It is more often seen in placenta previa.

Choice D rationale:

"Threatened abortion.”. This choice is incorrect. Threatened abortion refers to vaginal bleeding in the first half of pregnancy, typically accompanied by mild uterine cramping. The bleeding is often associated with the possibility of miscarriage. However, the scenario described in the question occurs at 36 weeks of gestation, which is well into the third trimester and not within the typical timeframe for a threatened abortion.

Choice A rationale:

Calcium gluconate is the antidote for magnesium sulfate toxicity. Magnesium sulfate is commonly used to prevent seizures in clients with preeclampsia, but it can lead to respiratory depression and toxicity when levels become too high. Administering calcium gluconate helps counteract the effects of magnesium toxicity by competing for binding sites and restoring neuromuscular function. This is the appropriate treatment to address the client's symptoms of respiratory depression, which are suggestive of magnesium sulfate toxicity.

Choice B rationale:

Flumazenil is not the correct choice in this situation. Flumazenil is a medication used to reverse the effects of benzodiazepine overdose, not magnesium sulfate toxicity. It does not have any impact on magnesium levels or their associated toxic effects.

Choice C rationale:

Naloxone is used to reverse the effects of opioids, such as morphine or fentanyl. It is not indicated for magnesium sulfate toxicity. Administering naloxone would not address the client's symptoms or the underlying cause of respiratory depressionzz.

Choice D rationale:

Protamine sulfate is an antidote used to reverse the anticoagulant effects of heparin, not magnesium sulfate. It is not effective in treating magnesium sulfate toxicity. Administering protamine sulfate would not be the appropriate intervention for this situation.