Which of the following gravid clients is most appropriate for a charge nurse to assign to a new nurse with no obstetric (OB) experience?
32-week patient with preeclampsia receiving magnesium sulfate
9-week client with hyperemesis receiving IV therapy
34-week client with no fetal heartbeat
38-week client with complete previa
The Correct Answer is B
A. 32-week patient with preeclampsia receiving magnesium sulfate – Magnesium sulfate requires close monitoring for toxicity (e.g., respiratory depression, loss of deep tendon reflexes), making this client inappropriate for a nurse with no OB experience.
B. 9-week client with hyperemesis receiving IV therapy – This client is the most stable and requires routine care, such as IV fluid administration and antiemetics, making them the best assignment for a new nurse without OB experience.
C. 34-week client with no fetal heartbeat – This client requires significant emotional support and possibly induction of labor, making them inappropriate for a nurse unfamiliar with OB care.
D. 38-week client with complete previa – Placenta previa poses a high risk for hemorrhage, and this client requires close monitoring. A new nurse without OB experience would not be the best choice for this assignment.
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Correct Answer is C
Explanation
A. "We will monitor your blood pressure to see if it decreases."
While magnesium sulfate may have a mild antihypertensive effect, it is not primarily given to lower blood pressure; antihypertensives are used for that purpose.
B. "We will check for a reduction in swelling and fluid retention."
Edema in preeclampsia is due to capillary leakage and kidney dysfunction, not directly affected by magnesium sulfate.
C. "We will assess for a decrease in seizure activity and improved reflexes."
Magnesium sulfate is used primarily as a seizure prophylaxis in preeclampsia by stabilizing the central nervous system and reducing hyperreflexia and clonus, which are signs of worsening preeclampsia.
D. "You should feel less pain and have fewer headaches."
While magnesium sulfate can improve symptoms, it is not an analgesic and does not directly relieve pain.
Correct Answer is B
Explanation
A. 32-week patient with preeclampsia receiving magnesium sulfate – Magnesium sulfate requires close monitoring for toxicity (e.g., respiratory depression, loss of deep tendon reflexes), making this client inappropriate for a nurse with no OB experience.
B. 9-week client with hyperemesis receiving IV therapy – This client is the most stable and requires routine care, such as IV fluid administration and antiemetics, making them the best assignment for a new nurse without OB experience.
C. 34-week client with no fetal heartbeat – This client requires significant emotional support and possibly induction of labor, making them inappropriate for a nurse unfamiliar with OB care.
D. 38-week client with complete previa – Placenta previa poses a high risk for hemorrhage, and this client requires close monitoring. A new nurse without OB experience would not be the best choice for this assignment.
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