A nurse is caring for a client who has preeclampsia and is receiving magnesium sulfate. Which of the following clinical findings should the nurse instruct the client to report?
Increased respiratory rate
Increased fetal movement
Increased urinary output
Increased muscle weakness
The Correct Answer is D
When caring for a client with preeclampsia receiving magnesium sulfate, the nurse should instruct the client to report any increased muscle weakness. Magnesium sulfate is a medication commonly used to prevent and treat seizures in clients with preeclampsia. However, one of the side effects of magnesium sulfate is muscle weakness. If the client experiences an increase in muscle weakness, it could indicate magnesium toxicity, which requires immediate medical attention.
Option a) Increased respiratory rate is not typically associated with magnesium sulfate administration. However, respiratory depression is a potential side effect, so a decreased respiratory rate should be reported.
Option b) Increased fetal movement is generally considered a positive sign of fetal well-being and is not a concern that needs to be reported.
Option c) Increased urinary output is not typically a concerning finding. In fact, maintaining adequate urine output is desired in clients with preeclampsia to ensure proper kidney function. However, a sudden decrease in urinary output or signs of dehydration should be reported.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A, B, D, C
Explanation
- Compressing the bulb syringe before placing it in the newborn's mouth or nose creates a vacuum that allows the suctioning of the mucus¹².
- Placing the bulb syringe in the newborn's mouth first helps clear the oral airway and prevent aspiration of mucus into the lungs¹². The nozzle of the bulb syringe should be gently inserted into the corner of the mouth, not the center, to avoid stimulating the gag reflex¹².
- Using the bulb syringe to suction the newborns nose helps clear the nasal airway and improve breathing¹². The nozzle of the bulb syringe should be gently inserted into one nostril at a time, and not too far, to avoid injuring the nasal mucosa¹².
- Assessing the newborn for reflex bradycardia helps monitor for any adverse effects of suctioning, such as a decrease in heart rate due to vagal stimulation¹³. Reflex bradycardia can cause hypoxia and acidosis in newborns, and may require oxygen administration or resuscitation³. The normal heart rate for a newborn is 120 to 160 beats per minute³.
Correct Answer is ["3"]
Explanation
Use the following formula to calculate the amount of gentamicin to administer:
Volume (mL) = Dose (mg) / Concentration (mg/mL)
First, I need to convert the client's weight from pounds to kilograms. One pound is equal to 0.4536 kilograms. Therefore, 132 lb is equal to 132 x 0.4536 = 59.8752 kg.
Next, I need to multiply the client's weight by the prescribed dose of gentamicin per kilogram. The prescribed dose is 2 mg/kg, so the total dose is 2 x 59.8752 = 119.7504 mg.
Finally, I need to divide the total dose by the concentration of gentamicin in the injection. The concentration is 40 mg/mL, so the volume is 119.7504 / 40 = 2.99376 mL.
To round the answer to the nearest whole number, I need to look at the first decimal place. If it is 5 or more, I round up; if it is less than 5, I round down. In this case, the first decimal place is 9, which is more than 5, so I round up. Therefore, the final answer is 3 mL.
The nurse should administer 3 mL of gentamicin injection to the client.
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