(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
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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Related Questions
Correct Answer is C
Explanation
Calcium gluconate is the antidote for magnesium sulfate overdose.Magnesium sulfate blocks calcium, so calcium gluconate can reverse the effect of an overdose.
The other choices are not antidotes for magnesium sulfate.Choice A, naloxone, is the antidote for narcotics or opioid overdose.Choice B, flumazenil, is the antidote for benzodiazepine overdose.Choice D, protamine sulfate, is the antidote for heparin overdose.The normal range of magnesium level is 1.5 to 2.5 mEq/L, so a level of 10 mg/dL indicates toxicity.
Correct Answer is C
Explanation
Oligohydramnios on ultrasound.Oligohydramnios is a condition where the amniotic fluid volume is less than expected for gestational age.It can be a sign of fetal compromise due to various causes, such as renal abnormalities, placental insufficiency, premature rupture of membranes, or chromosomal anomalies.Oligohydramnios can lead to complications such as fetal deformities, preterm birth, infection, or stillbirth.
Choice A is wrong because a fetal heart rate of 140 beats/min is within the normal range for most of pregnancy.
Choice B is wrong because fetal movement of 10 times in an hour is also within the normal range and indicates fetal well-being.
Choice D is wrong because a reactive nonstress test is a reassuring sign that the fetus is not hypoxic or stressed.
Normal ranges:
• Amniotic fluid index (AFI): 5-25 cm
• Fetal heart rate: 110-160 beats/min
• Fetal movement: at least 10 movements in 2 hours
• Nonstress test: at least two accelerations of fetal heart rate of 15 beats/min for 15 seconds or more in 20 minutes
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