A nurse is monitoring a client who is at 29 weeks of gestation and has pre-term labor.

The client is receiving magnesium sulfate IV infusion.

Which of the following are expected adverse effects of this medication? (Select all that apply)

Lying on one’s back with knees bent while using the monitor is not recommended for women at risk of preterm labor, as it can put pressure on the inferior vena cava, a major vein leading back to the heart.This can cause low blood pressure and reduce blood flow to the uterus and the baby.A better position is to lie on one’s side with a pillow at the back for support.

Choice A is correct because emptying the bladder before applying the monitor can reduce interference from urine contractions and make the readings more accurate.

Choice C is correct because pressing the event marker every time one feels a contraction can help record the frequency and duration of uterine activity.

Choice D is correct because using the monitor for at least 1 hour twice a day can provide sufficient data on uterine contractions and help detect early signs of preterm labor.

Assess fetal heart rate and activity.

The nurse should identify that a client who reports a sudden gush of fluid from her vagina is at risk forpremature rupture of membranes (PROM), which can lead toinfection,cord prolapse, andfetal distress.Therefore, the priority action is to assess the fetal heart rate and activity to monitor for signs of hypoxia or distress.

Choice B is wrong because performing a nitrazine test on the fluid is not the first action.A nitrazine test can confirm the presence of amniotic fluid by detecting its alkaline pH, but it is not as urgent as assessing the fetal well-being.

Choice C is wrong because administering oxytocin (Pitocin) IV infusion is contraindicated in this situation.Oxytocin is used to induce or augment labor, but it can causeuterine hyperstimulation,fetal distress, andplacental abruptionif given to a client who has PROM.

Choice D is wrong because placing the client in Trendelenburg position is not recommended for a client who has PROM.Trendelenburg position can increase the risk ofcord prolapseandaspirationin this situation.