A woman with preeclampsia gave birth vaginally 1 hour ago. She is still receiving a magnesium sulfate infusion at 1 gm/hr. A major concern regarding the administration of magnesium sulfate at this time would be:
Diuresis
Hypotension
Increased risk for seizures
Excessive uterine bleeding.
The Correct Answer is D
A. Diuresis. Increased urine output is a positive sign in a postpartum woman with preeclampsia, indicating that fluid shifts are occurring and the kidneys are functioning well. Magnesium sulfate does not cause fluid retention, and diuresis is not a major concern at this time.
B. Hypotension. While magnesium sulfate can cause vasodilation, leading to a mild decrease in blood pressure, severe hypotension is not the primary concern. The main hemodynamic concern postpartum is ensuring adequate uterine tone and preventing hemorrhage.
C. Increased risk for seizures. Magnesium sulfate is given to prevent eclampsia-related seizures, and its continued administration postpartum helps reduce seizure risk. The risk of seizures decreases after delivery, but stopping the infusion too early could increase the risk, making this a secondary rather than primary concern.
D. Excessive uterine bleeding. Magnesium sulfate relaxes smooth muscle, including the uterus, which can lead to uterine atony and increased postpartum hemorrhage risk. This is a critical concern in the immediate postpartum period, as uterine atony can result in life-threatening blood loss requiring urgent intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. The patient will deliver a baby that is appropriate for gestational age. While cerclage helps prevent preterm birth, it does not directly influence fetal growth or ensure that the baby will be appropriate for gestational age (AGA). Factors such as maternal nutrition, placental function, and genetics play a larger role in fetal growth.
B. The patient will have a normal blood glucose throughout the pregnancy. Cerclage is performed to prevent cervical insufficiency and preterm birth, not to regulate blood glucose. Maintaining normal blood sugar levels is important for pregnancy outcomes but is unrelated to this procedure.
C. The patient will deliver after 38 weeks' gestation. The primary goal of a cerclage is to prevent preterm birth by reinforcing the cervix and allowing the pregnancy to progress to term. Women with a history of second-trimester pregnancy losses or cervical insufficiency benefit from this procedure to increase the likelihood of delivering at or near term.
D. The patient will gain less than 25 pounds during the pregnancy. Weight gain recommendations are based on maternal BMI and nutritional status, not the need for a cerclage. The procedure does not directly affect maternal weight gain.
Correct Answer is A
Explanation
True.
When supporting a woman who has just experienced a fetal demise, it is appropriate and compassionate to:
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Offer supportive care.
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Allow and encourage space and time to grieve.
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Offer the services of a chaplain, especially if the patient expresses a desire for spiritual or emotional support.
Chaplains are typically trained to be non-denominational and sensitive to a wide range of beliefs, and they can provide comforting words and presence regardless of the patient’s faith or lack thereof. This approach aligns with holistic and patient-centered care.
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