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

While rupturing membranes can be a concern, the primary issue with a vaginal exam in the presence of placenta previa is the risk of severe bleeding. This choice is partially correct but not the most accurate answer.

Choice B rationale

With placenta previa, the placenta covers the cervix, and a vaginal exam could easily disrupt it, leading to significant vaginal bleeding. This bleeding can be dangerous for both the mother and the baby, making this the most accurate reason to avoid a vaginal exam.

Choice C rationale

Infection risk is a concern with any invasive procedure, but it is not the primary reason to avoid a vaginal exam in the case of placenta previa. The main concern is the risk of bleeding.

Choice D rationale

Initiating preterm labor is a possible risk with any vaginal exam late in pregnancy, but it is not the primary concern in cases of placenta previa. The main issue is the potential for causing severe bleeding.

Choice A rationale

Nifedipine is a calcium channel blocker and can lower blood pressure, but this is not its primary intended effect in this scenario.

Choice B rationale

While nifedipine can increase heart rate as a side effect, this does not indicate its primary effectiveness.

Choice C rationale

Nifedipine effectively decreases uterine contractions in preterm labor by inhibiting calcium entry into muscle cells, thus reducing their contractility.

Choice D rationale

Nifedipine does not directly decrease nausea, so this is not an appropriate measure of its effectiveness.