(select all that apply) A nurse is reviewing the laboratory results of a client with eclampsia who is receiving magnesium sulfate.

Which of the following values should the nurse report to the provider? (Select all that apply.)

Serum magnesium level of 8 mg/dL

Serum calcium level of 7 mg/dL

Serum creatinine level of 1.2 mg/dL

Serum potassium level of 3.8 mEq/L

Serum sodium level of 140 mEq/L

Answer and Explanation

Correct Answer : A,B

The correct answer is A and B. A. Serum magnesium level of 8 mg/dL

This statement is correct because a serum magnesium level of 8 mg/dL (6.6 mmol/L) is within the therapeutic range for eclampsia treatment, which is 3.5 to 7 mEq/L (4.2 to 8.4 mg/dL) according to some sources, or 1.5 to 3.5 mmol/L according to others. A serum magnesium level above 8 mEq/L (10 mmol/L) can cause areflexia, respiratory paralysis, and cardiac arrest.

B. Serum calcium level of 7 mg/dL

This statement is correct because a serum calcium level of 7 mg/dL (1.75 mmol/L) is below the normal range of 8.5 to 10.2 mg/dL (2.12 to 2.55 mmol/L), which indicates hypocalcemia. Hypocalcemia is a common side effect of magnesium sulfate therapy, as magnesium competes with calcium for binding sites on plasma proteins and cell membranes, and also inhibits the release of parathyroid hormone.

C. Serum creatinine level of 1.2 mg/dL

This statement is wrong because a serum creatinine level of 1.2 mg/dL (106 umol/L) is within the normal range of 0.6 to 1.3 mg/dL (53 to 115 umol/L) for women. Serum creatinine level reflects kidney function, and renal impairment can affect the clearance of magnesium sulfate and increase the risk of toxicity.

D. Serum potassium level of 3.8 mEq/L

This statement is wrong because a serum potassium level of 3.8 mEq/L (3.8 mmol/L) is within the normal range of 3.5 to 5 mEq/L (3.5 to 5 mmol/L) for adults. Serum potassium level reflects electrolyte balance, and hypokalemia or hyperkalemia can affect cardiac function and muscle contraction.

E. Serum sodium level of 140 mEq/L

This statement is wrong because a serum sodium level of 140 mEq/L (140 mmol/L) is within the normal range of 135 to 145 mEq/L (135 to 145 mmol/L) for adults. Serum sodium level reflects fluid balance, and hyponatremia or hypernatremia can affect brain function and blood pressure.

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Correct Answer is A

Explanation

The client has no seizures or eclampsia.This outcome would indicate that the magnesium sulfate therapy is successful because magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia.

Some additional information for the other choices are:

• Choice B. The client delivers a healthy baby vaginally.

This outcome is desirable but not directly related to the effectiveness of magnesium sulfate therapy.Magnesium sulfate can help prolong a pregnancy for up to two days to allow drugs that speed up the baby’s lung development to be administered, but it does not guarantee a vaginal delivery or a healthy baby.

• Choice C. The client has normal blood pressure and urine output.

This outcome is also desirable but not directly related to the effectiveness of magnesium sulfate therapy.

Magnesium sulfate may help reduce blood pressure in some cases, but it is not the primary treatment for hypertension in preeclampsia.Other medications such as antihypertensives are usually prescribed for that purpose.Urine output should be monitored closely while receiving magnesium sulfate therapy, as a decrease may indicate toxicity or kidney impairment.Urine output should be at least 30 mL/hour while administering magnesium sulfate.

• Choice D. The client has improved liver function and platelet count.

This outcome is also desirable but not directly related to the effectiveness of magnesium sulfate therapy.

Magnesium sulfate does not affect liver function or platelet count in preeclampsia.These parameters may improve after delivery of the placenta, which is the main cause of preeclampsia.

Normal ranges for blood pressure, urine output, liver function and platelet count are:

• Blood pressure: less than 140/90 mm Hg

• Urine output: at least 30 mL/hour

• Liver function: AST and ALT less than 40 U/L, LDH less than 600 U/L, bilirubin less than 1.2 mg/dL

• Platelet count: 150,000 to 450,000 per microliter of blood

A. Monitor vital signs and urine output B. Administer corticosteroids as prescribed C. Check for signs of fluid overload or transfusion reaction D. Encourage oral intake of fluids and electrolytes E. Maintain bed rest and a quiet environment

Correct Answer is ["A","C"]

Explanation

The correct answer is choice A and C. A client with HELLP syndrome is at risk for bleeding, liver damage, and fluid overload or transfusion reaction.Therefore, the nurse should monitor vital signs and urine output to assess for signs of shock, hemorrhage, or renal failure.The nurse should also check for signs of fluid overload or transfusion reaction such as dyspnea, crackles, edema, fever, chills, or rash.

Choice B is wrong because corticosteroids are not indicated for clients with HELLP syndrome unless they have severe thrombocytopenia or need to delay delivery for fetal lung maturity.Corticosteroids may worsen the liver function and increase the risk of infection.

Choice D is wrong because encouraging oral intake of fluids and electrolytes may exacerbate fluid overload and hypertension in clients with HELLP syndrome.Fluid restriction and diuretics may be prescribed to reduce the risk of pulmonary edema and cerebral edema.

Choice E is wrong because maintaining bed rest and a quiet environment may not be sufficient to prevent the progression of HELLP syndrome.The definitive treatment for HELLP syndrome is delivery of the fetus and placenta as soon as possible.Bed rest and a quiet environment may help reduce blood pressure and stress, but they are not the main interventions for this condition.

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(select all that apply) A nurse is reviewing the laboratory results of a client with eclampsia who is receiving magnesium sulfate. Which of the following values should the nurse report to the provider? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is evaluating the effectiveness of magnesium sulfate therapy for a client with pre-eclampsia. Which outcome would indicate that the therapy is successful?

Correct Answer is A

Explanation

A nurse is caring for a client with HELLP syndrome who is receiving a blood transfusion. What nursing interventions are appropriate for this client? Select all that apply.

Correct Answer is ["A","C"]

Explanation

A nurse is educating a client with severe pre-eclampsia who is receiving magnesium sulfate intravenously about the possible side effects of the medication. Which of the following statements should the nurse include in the teaching?

A nurse is assessing a client with severe pre-eclampsia who is receiving magnesium sulfate infusion. Which finding should alert the nurse to suspect magnesium toxicity?

A nurse is providing discharge instructions to a client who had preeclampsia and delivered her baby 2 days ago. Which of the following instructions should the nurse include?

A nurse is evaluating the effectiveness of magnesium sulfate therapy for a client who has eclampsia. Which of the following outcomes indicates that the therapy is successful?

A nurse is assessing a client who is 24 weeks pregnant and has preeclampsia. Which of the following findings should the nurse report to the provider as a manifestation of severe preeclampsia?

A nurse is evaluating the fetal status of a client who has preeclampsia and is receiving magnesium sulfate. Which of the following findings should the nurse report to the provider as a sign of fetal compromise?

A nurse is evaluating the effectiveness of magnesium sulfate therapy for a client with eclampsia. What clinical indicator would suggest that the therapy is successful?

(select all that apply) A nurse is reviewing the laboratory results of a client with eclampsia who is receiving magnesium sulfate. Which of the following values should the nurse report to the provider? (Select all that apply.)

(select all that apply) A nurse is reviewing the laboratory results of a client with eclampsia who is receiving magnesium sulfate.

Which of the following values should the nurse report to the provider? (Select all that apply.)