A nurse is caring for a client who has a prescription for Magnesium Sulfate IV. The nurse would recognize that which of the following are contraindications for the use of this medication? Select all that apply
Acute fetal distress
Gestational Diabetes Mellitus
Active labor at term
Severe Preeclampsia
Vaginal bleeding
Correct Answer : A,C,E
A. Acute fetal distress is a contraindication because magnesium sulfate acts as a tocolytic, relaxing the uterus to suppress contractions. If the fetus is already in distress, inhibiting labor can delay delivery, prolong hypoxia, and worsen outcomes. In such cases, immediate delivery is prioritized, and magnesium sulfate should be withheld.
B. Gestational Diabetes Mellitus is not a contraindication. Clients with GDM may safely receive magnesium sulfate for seizure prophylaxis in preeclampsia or for preterm labor, though blood glucose should be closely monitored, as magnesium can occasionally affect insulin sensitivity.
C. Active labor at term is a contraindication because tocolysis is unnecessary and potentially harmful once the pregnancy has reached term. Suppressing contractions at this stage can increase maternal and fetal risks, such as prolonged labor, infection, and fetal compromise, and is therefore avoided.
D. Severe preeclampsia is an indication, not a contraindication. Magnesium sulfate is the drug of choice for preventing eclampsia by reducing the risk of maternal seizures. It is administered carefully with close monitoring of reflexes, respiratory status, and urine output to prevent toxicity.
E. Vaginal bleeding is a contraindication because it may indicate placental abruption, placenta previa, or other obstetric emergencies where immediate delivery is necessary. Administering magnesium sulfate in these situations could mask uterine tone, delay delivery, and worsen maternal-fetal outcomes, making it unsafe.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. G4 T3 P0 A0 L2 is incorrect because the client has only two term deliveries, not three, and she has had one preterm birth.
B. G4 T2 P1 A0 L2 is correct based on the following OB history:
- G (Gravida) = 4: She has been pregnant four times, including the current pregnancy.
- T (Term) = 2: Two deliveries occurred at term (40.4 weeks and 37 weeks).
- P (Preterm) = 1: One infant was born preterm at 34 weeks.
- A (Abortions) = 0: There is no history of miscarriage or elective termination before 20 weeks.
- L (Living) = 2: Two children are currently living. The infant born at 37 weeks died at 2 months and is not counted as living.
C. G4 T2 P1 A0 L3 is incorrect because only two children are living, not three.
D. G4 T1 P2 A0 L3 is incorrect because the client has two term deliveries, not one, and only one preterm delivery.
Correct Answer is A
Explanation
A. This is the highest priority intervention. The scenario describes a prolapsed umbilical cord, a life-threatening obstetric emergency. When the cord is compressed between the fetus and the maternal pelvis, blood flow through the umbilical cord is reduced, leading to fetal hypoxia, acidosis, or even fetal death if not corrected immediately. The nurse must insert a sterile gloved hand into the vagina and gently lift or hold the presenting part off the cord to relieve pressure. This action restores oxygenated blood flow to the fetus while preparing for emergency delivery, typically via cesarean section.
B. This is dangerous and contraindicated. Ambulation or movement would increase pressure on the prolapsed cord, worsening cord compression and accelerating fetal hypoxia. The client should remain immobilized and positioned to relieve pressure on the cord.
C. While maternal positioning is important to reduce cord compression, placing the client supine alone is insufficient. Evidence-based positions include knee-chest or Trendelenburg, which use gravity to reduce pressure on the cord. However, the manual elevation of the presenting part is the immediate priority, with positioning as an adjunct.
D. This is inappropriate in this scenario. Oxytocin stimulates uterine contractions, which would increase pressure on the prolapsed cord, worsening fetal oxygen deprivation. Administering oxytocin before relieving cord compression is dangerous and could precipitate severe fetal compromise.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
