A nurse is assessing a client who received magnesium sulfate to treat preterm labor. Which of the following clinical findings should the nurse identify as an indication of toxicity of magnesium sulfate therapy and report to the provider?

Drowsiness

Facial flushing

Nausea

Respiratory depression

Answer and Explanation

The Correct Answer is D

Explanation:

A. Drowsiness: Mild drowsiness is a common side effect of magnesium sulfate therapy and is not necessarily indicative of toxicity. However, severe drowsiness or lethargy can be a sign of magnesium toxicity and should be reported to the provider.

B. Facial flushing: Facial flushing is a common side effect of magnesium sulfate administration and is generally not a sign of toxicity. It is often accompanied by warmth and redness of the skin but is not considered a serious adverse reaction.

C. Nausea: Nausea is another common side effect of magnesium sulfate therapy and is usually mild and transient. It is not typically indicative of toxicity unless it is severe and persistent.

D. Respiratory depression: Respiratory depression is a critical sign of magnesium toxicity. Excessive levels of magnesium can affect neuromuscular function, leading to respiratory muscle weakness and depression. This can result in shallow or slowed breathing, decreased oxygenation, and potential respiratory failure. Respiratory depression is a serious complication that requires immediate intervention, and the nurse should report it to the provider promptly.

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Correct Answer is A

Explanation

Explanation:

A. A client who is at 38 weeks of gestation and reports a cough and fever.

The client at 38 weeks of gestation with a cough and fever presents with symptoms that could indicate a potential infection, such as respiratory or urinary tract infection, which can be serious during pregnancy. Infections in late pregnancy can also increase the risk of complications for both the mother and the baby. Therefore, assessing this client first is crucial to evaluate and address any potential infection and prevent complications.

B. A client who is at 28 weeks of gestation and reports painless vaginal bleeding.

Painless vaginal bleeding can be a concern, especially in the second or third trimester, as it may indicate conditions such as placenta previa or placental abruption. However, since this client's bleeding is painless, it may not be an immediate emergency compared to the potential infection in option A.

C. A client who is at 14 weeks of gestation and reports nausea and vomiting.

Nausea and vomiting, commonly known as morning sickness, are common during early pregnancy. While these symptoms can be uncomfortable, they are typically not urgent unless they lead to dehydration or other complications, which would require assessment but may not be as urgent as a potential infection in option A.

D. A client who has missed a period and reports vaginal spotting.

Vaginal spotting can occur in early pregnancy and may or may not be concerning depending on the amount and frequency. Since this client has missed a period, it suggests early pregnancy, and spotting can be relatively common in early pregnancy without indicating a significant problem. However, assessment is still needed to rule out any potential complications.

A. "A gain of about 1 pound per week is the best pattern for you." B. "It would be best if you gained about 11 to 20 pounds." C. "The recommendation for you is about 15 to 25 pounds." D. "A gain of about 25 to 35 pounds is recommended for you."

Correct Answer is C

Explanation

Explanation:

A. "A gain of about 1 pound per week is the best pattern for you."

This response suggests a weight gain pattern rather than a total recommended weight gain for the entire pregnancy. A gain of about 1 pound per week would typically align with the recommended weight gain for individuals with a normal pre-pregnancy BMI (Body Mass Index). However, for someone with an overweight BMI (BMI 25 to 29.9), this rate of weight gain might be higher than the recommended range. Therefore, it may not be the best pattern for the client with a BMI of 26.5.

B. "It would be best if you gained about 11 to 20 pounds."

This response provides a weight gain range that is more appropriate for individuals with an obese BMI (BMI 30 or higher) rather than those with an overweight BMI. The recommended weight gain for someone with an overweight BMI is higher than 11 to 20 pounds. Therefore, this response underestimates the recommended weight gain for the client with a BMI of 26.5.

C. "The recommendation for you is about 15 to 25 pounds."

This response aligns with the recommended weight gain range for individuals with an overweight BMI (BMI 25 to 29.9). According to the Institute of Medicine (IOM) guidelines, the recommended weight gain for someone with an overweight BMI is about 15 to 25 pounds during pregnancy. This choice accurately reflects the appropriate recommendation for the client with a BMI of 26.5.

D. "A gain of about 25 to 35 pounds is recommended for you."

This response suggests a weight gain range that is more appropriate for individuals with a normal pre-pregnancy BMI (BMI 18.5 to 24.9). The recommended weight gain for someone with an overweight BMI is lower than 25 to 35 pounds. Therefore, this response overestimates the recommended weight gain for the client with a BMI of 26.5.

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