A newborn who weighs 4300 grams is receiving ampicillin 2mg/kg IV once per day.

The vial reads 20mg/mL. How much will the nurse draw up in the syringe for one dose?

(Enter your answer in numbers only. No units.)

Choice A rationale

Administering epinephrine before the procedure is not standard practice to prevent hypotension associated with epidurals. Epinephrine is used in emergency situations to treat severe allergic reactions or cardiac arrest, not for preventing epidural-induced hypotension.

Choice B rationale

Positioning the client on her back prior to the procedure is not recommended, as it can exacerbate hypotension due to compression of the inferior vena cava by the gravid uterus. This position can decrease venous return to the heart and reduce cardiac output.

Choice C rationale

Having the patient eat a carbohydrate snack prior to the procedure is not a standard intervention to prevent hypotension during an epidural. Dietary intake does not directly prevent the vasodilatory effects of the epidural anesthesia.

Choice D rationale

Administering a bolus of 0.9% Normal saline IV fluid before the procedure is the correct intervention to prevent hypotension. Preloading with IV fluids increases intravascular volume, counteracting the vasodilation and potential drop in blood pressure caused by the epidural anesthesia. .

Choice A rationale

Respiratory rate of 8 breaths per minute indicates respiratory depression, a serious adverse effect of magnesium sulfate toxicity. Magnesium sulfate can depress neuromuscular transmission, leading to decreased respiratory effort and rate.

Choice B rationale

Blood pressure of 150/90 mmHg is not indicative of magnesium sulfate toxicity. Elevated blood pressure is a symptom of pre-eclampsia and not directly related to the adverse effects of magnesium sulfate. Therefore, it does not indicate toxicity.

Choice C rationale

Lung crackles are typically associated with fluid overload or heart failure rather than magnesium sulfate toxicity. While it is a serious condition, it is not specifically an adverse effect of magnesium sulfate.

Choice D rationale

Increase in fetal heart rate is not a common adverse effect of magnesium sulfate. Fetal heart rate changes are more commonly related to the underlying maternal condition or other medications used in pregnancy rather than magnesium sulfate.

Choice E rationale

Deep tendon reflexes would typically be decreased or absent in magnesium sulfate toxicity. Therefore, presence of deep tendon reflexes would not indicate an adverse effect of magnesium sulfate.

Choice F rationale

Confusion can occur due to central nervous system depression caused by high levels of magnesium sulfate. This is a significant adverse effect indicating possible toxicity.

Choice G rationale

Urine output of 30 mL in 2 hours suggests oliguria, which can be a sign of magnesium sulfate toxicity as the drug is excreted through the kidneys. Reduced urine output can indicate the kidneys are not clearing the drug efficiently, leading to toxicity.