A nurse is reviewing the laboratory results of a client with severe pre-eclampsia who is receiving magnesium sulfate.
Which finding would indicate a therapeutic level of magnesium sulfate?
Serum magnesium level of 4.5 mEq/L
Serum calcium level of 8.5 mg/dL
Serum creatinine level of 1.2 mg/dL
Serum potassium level of 3.5 mEq/L
The Correct Answer is A
This indicates a therapeutic level of magnesium sulfate for a client with severe pre-eclampsia who is receiving magnesium sulfate. According to some sources, the effective therapeutic serum magnesium level is 1.8–3.0 mmol/L, which corresponds to 4.2–7 mg/dL or 3.5–7 mEq/L.
Choice B is wrong because serum calcium level of 8.5 mg/dL is within the normal range and does not indicate the effect of magnesium sulfate.
Choice C is wrong because serum creatinine level of 1.2 mg/dL is within the normal range and does not indicate the effect of magnesium sulfate.
Choice D is wrong because serum potassium level of 3.5 mEq/L is at the lower end of the normal range and does not indicate the effect of magnesium sulfate.
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Related Questions
Correct Answer is A
Explanation
The most likely explanation for the client's findings of severe headache, blurred vision, hyperreflexia, and clonus in the context of severe pre-eclampsia is A. Cerebral edema.
Pre-eclampsia is a pregnancy-related condition characterized by high blood pressure (hypertension) and signs of organ damage, most commonly affecting the liver and kidneys. Severe pre-eclampsia can lead to complications such as eclampsia, which is characterized by seizures. The symptoms described by the client, including severe headache and blurred vision, are consistent with neurological manifestations associated with severe pre-eclampsia.
Hyperreflexia refers to an exaggerated reflex response, and clonus refers to rhythmic contractions of a muscle when it is passively stretched. Both hyperreflexia and clonus are indicative of central nervous system (CNS) hyperexcitability. Cerebral edema, which is the swelling of the brain due to fluid accumulation, can lead to increased intracranial pressure and neurological symptoms such as headache, vision changes, hyperreflexia, and clonus.
While other complications such as pulmonary edema (B), hemolysis (C), and thrombocytopenia (D) can occur in severe pre-eclampsia, they are not directly associated with the reported symptoms of severe headache, blurred vision, hyperreflexia, and clonus.
Pre-eclampsia is a pregnancy-related condition characterized by high blood pressure (hypertension) and signs of organ damage, most commonly affecting the liver and kidneys. Severe pre-eclampsia can lead to complications such as eclampsia, which is characterized by seizures. The symptoms described by the client, including severe headache and blurred vision, are consistent with neurological manifestations associated with severe pre-eclampsia.
Hyperreflexia refers to an exaggerated reflex response, and clonus refers to rhythmic contractions of a muscle when it is passively stretched. Both hyperreflexia and clonus are indicative of central nervous system (CNS) hyperexcitability. Cerebral edema, which is the swelling of the brain due to fluid accumulation, can lead to increased intracranial pressure and neurological symptoms such as headache, vision changes, hyperreflexia, and clonus.
While other complications such as pulmonary edema (B), hemolysis (C), and thrombocytopenia (D) can occur in severe pre-eclampsia, they are not directly associated with the reported symptoms of severe headache, blurred vision, hyperreflexia, and clonus.
Correct Answer is C
Explanation
Encourage bed rest in a left lateral position.
This is because bed rest can lower blood pressure and improve blood flow to the placenta and the fetus.The left lateral position reduces pressure on the inferior vena cava, a large vein that carries blood from the lower body to the heart.
Choice A is wrong because magnesium sulfate is used to prevent seizures in severe preeclampsia or eclampsia, not mild preeclampsia.
Choice B is wrong because monitoring the fetal heart rate and movement is important, but not the priority for this client.
Choice D is wrong because educating the client about the signs of eclampsia is not urgent and may not prevent the progression of preeclampsia.Some signs of eclampsia are severe headaches, blurred vision, nausea, vomiting, abdominal pain and seizures.
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