A nurse on a postpartum unit is caring for a client.

Exhibits

For each finding, click to specify if the finding increases the client's risk for uterine atony or infection.

Rationale:

A. "You will need to change the IV dressing site once per week.": Central line dressings for TPN are typically changed every 48–72 hours for gauze or every 5–7 days for transparent dressings, or sooner if the dressing becomes damp, loose, or soiled, to reduce infection risk.

B. "You will need to warm the solution in the microwave before administration.": TPN solutions should never be microwaved due to the risk of uneven heating and nutrient degradation. They should be administered at room temperature.

C. "You will need to weigh the client twice per week.": Clients receiving TPN require daily weights to monitor fluid balance, nutritional status, and detect fluid retention or dehydration promptly. Twice-weekly measurements are insufficient for close monitoring.

D. "You will need to monitor the client's electrolytes daily.": TPN can cause rapid changes in fluid and electrolyte balance, so daily electrolyte monitoring allows timely adjustments to prevent complications such as hypo- or hypernatremia, hypokalemia, and metabolic imbalances.

A. Bradypnea: Hypermagnesemia depresses neuromuscular and central nervous system function, which can lead to slowed respiratory rate (bradypnea) and potentially respiratory failure in severe cases.

B. Personality change: Personality changes are more commonly associated with hyponatremia, hypernatremia, or other electrolyte imbalances affecting the brain, rather than hypermagnesemia.

C. Seizure: Seizures are more likely in hypomagnesemia due to increased neuromuscular excitability, not in hypermagnesemia, which generally causes neuromuscular depression.

D. Elevated hematocrit: Hypermagnesemia does not directly affect red blood cell concentration or hematocrit levels. Changes in hematocrit are usually related to fluid volume status, not magnesium levels.