A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes concerned after assessment when the woman exhibits:

Choice A reason: An antiemetic such as pyridoxine may be used to control vomiting in women with hyperemesis gravidarum, but it is not the initial treatment. The first priority is to restore fluid and electrolyte balance and prevent dehydration and hypovolemia.

Choice B reason: IV therapy is the initial treatment for women with hyperemesis gravidarum. It helps to correct fluid and electrolyte imbalances, prevent dehydration and hypovolemia, and restore normal blood pressure and urine output. IV fluids may also contain glucose, vitamins, and electrolytes to replenish losses.

Choice C reason: Enteral nutrition may be used to meet nutritional needs in women with hyperemesis gravidarum, but it is not the initial treatment. Enteral nutrition involves feeding through a tube inserted into the stomach or intestine. It may be considered if oral intake is not tolerated or adequate after IV therapy.

Choice D reason: Corticosteroids are not used to treat hyperemesis gravidarum. They are used to reduce inflammation in conditions such as asthma, rheumatoid arthritis, and allergic reactions. They have no effect on nausea and vomiting in pregnancy.

Choice A reason: A sleepy, sedated affect is not a concerning sign, as it is a common side effect of magnesium sulfate. Magnesium sulfate is a central nervous system depressant that can cause drowsiness, lethargy, and reduced alertness.

Choice B reason: Absent ankle clonus is not a concerning sign, as it indicates a normal neuromuscular response. Ankle clonus is a rhythmic jerking of the foot when the ankle is dorsiflexed. It is a sign of hyperreflexia, which can occur in severe preeclampsia due to increased blood pressure and cerebral edema.

Choice C reason: A respiratory rate of 10 breaths/min is a concerning sign, as it indicates respiratory depression. This is a serious complication of magnesium sulfate toxicity, which can lead to respiratory arrest and death. The nurse should monitor the woman's respiratory rate closely and report any signs of respiratory distress.

Choice D reason: Deep tendon reflexes of 2+ are not a concerning sign, as they indicate a normal neuromuscular response. Deep tendon reflexes are graded from 0 to 4, with 2 being the average. Magnesium sulfate can cause hyporeflexia or areflexia, which are signs of magnesium sulfate toxicity.