A woman with severe preeclampsia is being treated with bed rest and intravenous magnesium sulfate. The drug classification of this medication is

Choice a) Insert an indwelling urinary catheter is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Inserting an indwelling urinary catheter can cause trauma to the cervix or the placenta, which can worsen the bleeding and endanger the mother and the fetus. Therefore, this action should be avoided unless absolutely necessary.

Choice b) Prepare the abdominal and perineal areas is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Preparing the abdominal and perineal areas can be done before performing a cesarean section, which is usually the preferred mode of delivery for placenta previa. However, this action should be done after stabilizing the client's condition and obtaining informed consent for surgery.

Choice c) Witness the signature for informed consent for surgery is incorrect because this is not a priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery.

Witnessing the signature for informed consent for surgery can be done before performing a cesarean section, which is usually the preferred mode of delivery for placenta previa. However, this action should be done after stabilizing the client's condition and explaining the risks and benefits of surgery.

Choice d) Initiate IV access is correct because this is the priority action for a client who has a large amount of painless, bright red vaginal bleeding. This type of bleeding is suggestive of placenta previa, which is a condition where the placenta covers part or all of the cervix, preventing normal delivery. Initiating IV access can help to restore fluid volume, prevent hypovolemic shock, administer medications such as oxytocin or blood products if needed, and prepare for emergency cesarean section if indicated. Therefore, this action should be done as soon as possible to save the life of the mother and the fetus.

Choice A: This is incorrect because weight less than the 10th percentile (SGA) means that the infant is smaller than expected for the gestational age, but not necessarily low birth weight. SGA infants may have intrauterine growth restriction due to maternal, placental, or fetal factors, but they may also be constitutionally small. SGA infants are at risk for hypoglycemia, hypothermia, polycythemia, and perinatal asphyxia.

Choice B: This is incorrect because weight greater than the 90th percentile means that the infant is larger than expected for the gestational age, but not necessarily high birth weight. Infants with weight greater than the 90th percentile are called large for gestational age (LGA) or macrosomic. LGA infants may have maternal diabetes, genetic factors, or post-term pregnancy as causes, but they may also be constitutionally large. LGA infants are at risk for birth trauma, shoulder dystocia, hypoglycemia, and respiratory distress.

Choice C: This is incorrect because weight between the 10th and 90th percentile means that the infant is appropriate for the gestational age (AGA), but not necessarily normal birth weight. AGA infants have a weight that matches their gestational age and are considered healthy and well-nourished. However, some AGA infants may have low or high birth weight depending on their gestational age at birth.

Choice D: This is the correct answer because low birth weight (LBW) is defined as a weight of 2500g or less at birth, regardless of the gestational age. LBW infants may be preterm (born before 37 weeks of gestation), term (born between 37 and 42 weeks of gestation), or post-term (born after 42 weeks of gestation). LBW infants are at risk for infection, bleeding, jaundice, and neurodevelopmental problems.