A nurse is assessing a client who is 24 weeks pregnant and has preeclampsia.

Which of the following findings should the nurse report to the provider as a manifestation of severe preeclampsia?

The client has no seizures or eclampsia.This outcome would indicate that the magnesium sulfate therapy is successful because magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia.

Some additional information for the other choices are:

• Choice B. The client delivers a healthy baby vaginally.

This outcome is desirable but not directly related to the effectiveness of magnesium sulfate therapy.Magnesium sulfate can help prolong a pregnancy for up to two days to allow drugs that speed up the baby’s lung development to be administered, but it does not guarantee a vaginal delivery or a healthy baby.

• Choice C. The client has normal blood pressure and urine output.

This outcome is also desirable but not directly related to the effectiveness of magnesium sulfate therapy.

Magnesium sulfate may help reduce blood pressure in some cases, but it is not the primary treatment for hypertension in preeclampsia.Other medications such as antihypertensives are usually prescribed for that purpose.Urine output should be monitored closely while receiving magnesium sulfate therapy, as a decrease may indicate toxicity or kidney impairment.Urine output should be at least 30 mL/hour while administering magnesium sulfate.

• Choice D. The client has improved liver function and platelet count.

This outcome is also desirable but not directly related to the effectiveness of magnesium sulfate therapy.

Magnesium sulfate does not affect liver function or platelet count in preeclampsia.These parameters may improve after delivery of the placenta, which is the main cause of preeclampsia.

Normal ranges for blood pressure, urine output, liver function and platelet count are:

• Blood pressure: less than 140/90 mm Hg

• Urine output: at least 30 mL/hour

• Liver function: AST and ALT less than 40 U/L, LDH less than 600 U/L, bilirubin less than 1.2 mg/dL

• Platelet count: 150,000 to 450,000 per microliter of blood

Magnesium sulfate therapy is used to prevent seizures in women with preeclampsia, a complication of pregnancy characterized by high blood pressure and organ dysfunction.Seizures are a sign of eclampsia, a severe form of preeclampsia that can be life-threatening.

Therefore, if the therapy is successful, the woman should not have any seizures.

Choice B.Absence of proteinuria is wrong because proteinuria, or excess protein in urine, is a possible sign of preeclampsia, not eclampsia.

Proteinuria may not disappear even after magnesium sulfate therapy.

Choice C.Absence of edema is wrong because edema, or swelling, is a common symptom of pregnancy and may not be related to preeclampsia or eclampsia.

Edema may not disappear even after magnesium sulfate therapy.

Choice D.Absence of headache is wrong because headache is a symptom of preeclampsia, not eclampsia.

Headache may not disappear even after magnesium sulfate therapy.

Normal ranges for blood pressure are below 140/90 mm Hg and for protein in urine are below 300 mg per 24 hours.