A nurse is assessing the fetal heart rate and uterine activity of a client with severe pre-eclampsia who is receiving magnesium sulfate intravenously.
Which of the following findings should the nurse report to the provider immediately?
Fetal heart rate of 140 beats per minute
Uterine contractions every 10 minutes
Fetal heart rate decelerations
Uterine contractions lasting 60 seconds
The Correct Answer is C
C. Fetal heart rate decelerations.
Fetal heart rate decelerations are temporary drops in the fetal heart rate that can indicate fetal distress or lack of oxygen. There are three types of decelerations: early, late and variable. Early decelerations are benign and caused by compression of the fetus’s head during a uterine contraction. Late decelerations are caused by uteroplacental insufficiency, which is a decrease in blood flow to the placenta. Variable decelerations are the most common type and vary in shape, duration and intensity. They are often caused by cord compression or other factors that affect fetal oxygenation.
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A. Fetal heart rate of 140 beats per minute.
Statement is wrong because this is a normal fetal heart rate. The normal range for fetal heart rate is 120-160 beats per minute.
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B. Uterine contractions every 10 minutes.
Statement is wrong because this is a normal frequency for uterine contractions during early labor.
The normal range for uterine contractions is 5-10 minutes apart.
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D. Uterine contractions lasting 60 seconds.
Statement is wrong because this is a normal duration for uterine contractions during active labor.
The normal range for uterine contractions is 45-90 seconds long.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
This indicates that the client has respiratory depression, which is a sign of magnesium toxicity.Magnesium sulfate is given to prevent and treat seizures in clients with eclampsia, but it can also cause adverse effects such as hypotension, decreased urine output, absent or diminished reflexes, and cardiac arrest.
Choice B is wrong because urine output of 50 mL/hr is within the normal range and does not indicate magnesium toxicity.The nurse should monitor the client’s urine output closely and report any decrease below 30 mL/hr.
Choice C is wrong because serum magnesium level of 6 mg/dL is within the therapeutic range of 4 to 7 mg/dL for clients receiving magnesium sulfate.The nurse should monitor the client’s serum magnesium level regularly and report any increase above 8 mg/dL, which indicates toxicity.
Choice D is wrong because patellar reflex of 2+ is normal and does not indicate magnesium toxicity.The nurse should assess the client’s deep tendon reflexes frequently and report any decrease or absence of reflexes, which indicates toxicity.
Correct Answer is C
Explanation
To increase placental perfusion.
Hydralazine is an antihypertensive drug that dilates the blood vessels and lowers the blood pressure.By doing so, it improves the blood flow to the placenta and reduces the risk of fetal hypoxia and growth restriction.
Choice A is wrong because hydralazine does not prevent cerebral edema.
Cerebral edema is a complication of severe preeclampsia or eclampsia that can cause seizures, headaches, and visual disturbances.Hydralazine may lower the blood pressure and reduce the risk of stroke, but it does not directly affect the brain swelling.
Choice B is wrong because hydralazine does not reduce uterine contractions.
Uterine contractions are stimulated by oxytocin and prostaglandins, which are not affected by hydralazine.Hydralazine may cause reflex tachycardia, which can increase the cardiac output and uterine blood flow, but it does not alter the uterine muscle activity.
Choice D is wrong because hydralazine does not promote diuresis.
Diuresis is the increased production of urine by the kidneys.
Hydralazine may cause fluid retention and edema by activating the renin-angiotensin-aldosterone system, which increases sodium and water reabsorption.Hydralazine may also cause a decrease in renal perfusion and glomerular filtration rate, which can impair the kidney function and urine output.
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