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?

Explanation:

A. Excessive uterine enlargement

This choice is correct because a hydatidiform mole can cause rapid and excessive growth of the uterus due to the abnormal proliferation of placental tissue. This can lead to the uterus being larger than expected for the gestational age.

B. Profuse, clear vaginal discharge

This choice is not typically associated with a hydatidiform mole. While vaginal discharge can occur during pregnancy, a profuse and clear discharge is not specifically characteristic of a hydatidiform mole. Other causes, such as normal vaginal secretions or infections, could lead to such discharge.

C. Rapid decline in human chorionic gonadotropin (hCG) levels

This choice is not typical of a hydatidiform mole. In fact, one of the hallmarks of a molar pregnancy is an abnormally high level of hCG. The hCG levels may continue to rise instead of declining rapidly.

D. Irregular fetal heart rate

This choice is not associated with a hydatidiform mole because a molar pregnancy does not involve a viable fetus with a heartbeat. Instead, it is characterized by the abnormal growth of placental tissue, which can cause symptoms related to uterine enlargement and complications such as bleeding or preeclampsia, but not an irregular fetal heart rate.

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.