A laboring client with preeclampsia is prescribed magnesium sulfate 2g/h IVPB.

The pharmacy sent the IV to the unit labeled magnesium sulfate 20g/500mL normal saline.

To administer the correct dose, the nurse should set the pump to deliver how many milliliters per hour?

Choice A rationale

Intraamniotic infection (chorioamnionitis) is suspected due to the combination of prolonged rupture of membranes (25 hours), maternal fever (39.2°C), and fetal tachycardia (baseline of 175 bpm). These are key indicators of infection within the amniotic sac.

Choice B rationale

Pyelonephritis, an infection of the kidneys, is unlikely without the presence of symptoms such as flank pain, dysuria, and significant changes in urinalysis. The primary signs point towards intraamniotic infection.

Choice C rationale

Cholestasis of pregnancy primarily presents with intense itching, especially on the hands and feet, and does not typically involve fever or abnormal fetal heart rates. Thus, it is less likely in this scenario.

Choice D rationale

Placental abruption involves the separation of the placenta from the uterine wall before delivery, often presenting with abdominal pain, vaginal bleeding, and uterine contractions. The absence of these symptoms makes this diagnosis less likely.

Choice A rationale

Nausea is typically present in patients with a hydatidiform mole due to high hCG levels.

Choice B rationale

Category II fetal heart rate patterns are indicative of intermediate fetal compromise but are not specific to hydatidiform mole.

Choice C rationale

hCG levels are typically elevated, not decreased, in a hydatidiform mole due to the abnormal growth of trophoblastic tissue.

Choice D rationale

An enlarged uterus is a classic sign of a hydatidiform mole due to the overgrowth of placental tissue without a viable fetus.