A pregnant client is to receive Vancomycin during labor for GEBS prophylaxis.

The client is allergic to Penicillin and weighs 195 pounds.

Order: Vancomycin 1,750 grams IVPB Q8 hours until delivery.

Pharmacy sends 1,750 mg of Vancomycin in a 300 ml bag with instructions to infuse over 90 minutes.

What is the rate in ml/hr? Round to the nearest whole number.

Enter numeric value only.

Choice A rationale

Urinalysis results provide information about renal function and potential infections but are not the immediate priority for a client whose vitals and assessment are concerning. A neuro assessment is the priority to rule out central nervous system changes, which can indicate serious complications such as preeclampsia or eclampsia.

Choice B rationale

Assessment of edema is an important part of a full physical assessment, especially in a pregnant client, but it is not the next priority. While edema can be a sign of preeclampsia, it is a less immediate concern compared to neurological changes.

Choice C rationale

A neuro assessment is the priority because the client's concerning vital signs and assessment findings could be indicative of preeclampsia. Neurological symptoms such as headache, visual disturbances, or altered mental status are critical indicators of central nervous system involvement and potential progression to eclampsia.

Choice D rationale

While assessing intake and output and skin turgor is part of a complete assessment, especially for fluid status, it is not the immediate priority. A neuro assessment is a more critical and immediate action to evaluate for signs of central nervous system dysfunction. *.

Choice A rationale

Poor maternal weight gain during pregnancy is a significant risk factor for adverse fetal outcomes. Inadequate nutritional intake can lead to placental insufficiency, which compromises the transfer of essential nutrients and oxygen to the fetus. This can result in intrauterine growth restriction (IUGR) and, in severe cases, fetal distress due to chronic hypoxia and malnutrition, impacting organ development and overall fetal well-being.

Choice B rationale

Excessive weight gain during pregnancy is associated with risks such as gestational hypertension, preeclampsia, gestational diabetes, and macrosomia. This can lead to complications during labor, including shoulder dystocia and the need for a cesarean section. Excessive weight gain is not a consequence of poor weight gain; rather, they are two distinct and opposite scenarios with different clinical implications.

Choice C rationale

Regular, moderate exercise during pregnancy is generally considered safe and beneficial for both the mother and the fetus. It can help maintain a healthy weight, reduce the risk of gestational diabetes, and improve cardiovascular health. However, if the exercise is excessive without adequate caloric intake, it could contribute to poor weight gain, but exercise itself is not the direct cause of the associated fetal problems.

Choice D rationale

Decreased fetal movement is a potential sign of fetal distress and is often monitored closely by healthcare providers. It is more of a symptom or a consequence of underlying issues like placental insufficiency or poor fetal growth, which can be linked to poor maternal weight gain, rather than being the direct cause of the complications themselves. Therefore, it is a clinical sign, not a direct cause. *.