A woman is being treated for preterm labor with magnesium sulfate. Which finding by the nurse indicates magnesium sulfate toxicity?
Select one:

Choice A Reason: Fetal movements are an indicator of fetal well-being. You should count twice a day, and you should feel ten fetal movements in 2 hours. This is because this response provides accurate and clear instructions on how to perform kick counts, which are a simple and non-invasive method of monitoring fetal activity and health. Kick counts can help detect changes in fetal movement paterns that may indicate fetal distress or hypoxia.

Choice B Reason: Here is a computer printed information packet on how to do kick counts. This is an insufficient answer that does not address the patient's question or demonstrate effective communication skills. Providing writen information alone may not ensure the patient's understanding or compliance with kick counts.

Choice C Reason: Fetal kick counts are not a reliable indicator of fetal well-being in the third trimester. This is an incorrect answer that contradicts the evidence and guidelines on kick counts. Kick counts are recommended for all pregnant women, especially in the third trimester, when fetal movements are more noticeable and consistent.

Choice D Reason: It is not important to do kick counts because you have a low-risk pregnancy. This is an incorrect answer that discourages the patient from performing kick counts and may give her a false sense of security. Kick counts are important for all pregnant women, regardless of their risk status, as they can help identify potential problems that may require further evaluation or intervention.

Choice A Reason: Possible Meconium Aspiration Syndrome (MAS). This is an unlikely condition for this newborn, as MAS occurs when fetal stool (meconium) enters into the lungs before or during birth, causing airway obstruction, inflammation, and infection. MAS usually affects term or post-term infants who experience fetal distress or hypoxia in utero.

Choice B Reason: Possible polycythemia. This is an unrelated condition for this newborn, as polycythemia refers to an abnormally high number of red blood cells in the blood, which can increase blood viscosity and impair circulation.

Polycythemia may occur in infants who have delayed cord clamping, intrauterine growth restriction, maternal diabetes, or high altitude exposure.

Choice C Reason: Possible Transient Tachypnea of the Newborn (TTN). This is a less serious condition than RDS, as TTN is a mild respiratory problem that results from delayed clearance of fetal lung fluid after birth. TTN causes rapid breathing, nasal flaring, grunting, and mild cyanosis. It usually resolves within 24 to 48 hours after birth.

Choice D Reason: Possible Respiratory Distress Syndrome (RDS). This is a serious condition that requires immediate intervention and treatment, as RDS can lead to life-threatening complications such as pulmonary hemorrhage, pneumothorax, or bronchopulmonary dysplasia. RDS causes respiratory distress, nasal flaring, retractions, grunting, and central cyanosis. It usually occurs within minutes to hours after birth.