A nurse is caring for a client who is at 35 weeks of gestation and is receiving magnesium sulfate for treatment of preeclampsia.
Which of the following findings indicates that the medication is having the desired effect?

• Discontinue oxytocin infusion (Expected): The client has contractions every 1–2 minutes lasting 90–120 seconds, indicating uterine tachysystole. Stopping oxytocin is a primary intervention to reduce contraction frequency and duration, preventing further fetal hypoxia.
• Assist with amnioinfusion (Expected): Amnioinfusion can help dilute thick meconium-stained amniotic fluid or relieve cord compression, which can cause late decelerations and minimal variability in FHR. It is often used to improve fetal oxygenation during uterine hyperstimulation.
• Give 500 mL of lactated Ringer’s IV bolus (Expected): Increasing maternal hydration improves uteroplacental perfusion, which can be compromised during frequent contractions. This intervention helps restore blood volume and oxygen delivery to the fetus.
• Place the client in a side-lying position (Expected): Lateral positioning improves uterine blood flow by relieving pressure on the vena cava and optimizing cardiac output and fetal oxygenation.
• Give betamethasone 12 mg IM now (Unexpected): Betamethasone is administered antenatally to accelerate fetal lung maturity in preterm labor (before 34 weeks). This client is at 38 weeks gestation, so corticosteroids are not indicated.

Choice A rationale

Consuming 27 mg of iron daily is within the recommended intake for pregnant individuals, which is typically around 27 mg per day. Iron is crucial for fetal growth and preventing maternal anemia, and this intake level supports healthy pregnancy outcomes, indicating a reduced risk factor.

Choice B rationale

Consuming 300 mg of caffeine daily is considered a high-risk lifestyle factor during pregnancy. High caffeine intake is associated with an increased risk of miscarriage, preterm birth, and low birth weight infants. The recommended limit for pregnant individuals is generally below 200 mg per day to mitigate these risks.

Choice C rationale

Consuming 3 L (101 oz) of water daily is a healthy practice during pregnancy. Adequate hydration is essential for maintaining blood volume, amniotic fluid levels, and preventing constipation and urinary tract infections. This intake level supports maternal and fetal health.

Choice D rationale

Consuming 400 mcg of folate daily is the recommended intake for pregnant individuals, particularly in the periconceptional period. Folic acid supplementation significantly reduces the risk of neural tube defects in the fetus, promoting a healthy pregnancy outcome and indicating a reduced risk factor.