A woman is being treated for preterm labor with magnesium sulfate. Which finding by the nurse indicates magnesium sulfate toxicity?
Select one:

Choice A Reason: "Our baby's newborn rash is from this syndrome." This is because this statement by a parent indicates that additional teaching is required, as it shows a misunderstanding or confusion about FAS and its manifestations. FAS is a condition that occurs when a woman consumes alcohol during pregnancy, which can affect the development and function of various organs and systems in the fetus and child. FAS can cause physical, behavioral, and cognitive problems such as facial abnormalities, growth retardation, learning difficulties, and atention deficits. FAS does not cause newborn rash, which is a common and benign condition that affects many newborns regardless of maternal alcohol intake. Newborn rash is also known as erythema toxicum neonatorum or baby acne, which is characterized by small red bumps or pustules on the face, chest, or back that usually disappear within a few weeks.

Choice B Reason: "His face looks like it does due to this problem." This is a correct answer that indicates adequate understanding of FAS and its features. Facial abnormalities are one of the characteristic signs of FAS, which include small eye openings, thin upper lip, flat nasal bridge, and smooth philtrum (the groove between the nose and upper lip).

Choice C Reason: "He can show signs of withdrawal from alcohol exposure like jiteriness, sweating, hyper reflexes, poor feeding and not sleeping well." This is a correct answer that indicates adequate understanding of FAS and its complications. Signs of withdrawal are possible effects of FAS, which occur when the fetus or newborn is exposed to alcohol in utero or through breast milk, which can cause neurotoxicity and dependency. Signs of withdrawal can include jiteriness, sweating, hyper reflexes, poor feeding, and not sleeping well, as well as irritability, seizures, or tremors.

Choice D Reason: "He is at risk of having intellectual disabilities, so we will need to get extra services to support him." This is a correct answer that indicates adequate understanding of FAS and its implications. Intellectual disabilities are potential outcomes of FAS, which affect the cognitive development and function of the child. Intellectual disabilities can cause problems with memory, Reasoning, language, and social skills. Extra services and support may be needed to help the child achieve their optimal potential and quality of life.

Choice A Reason: Retained placental fragments. This is an incorrect answer that refers to a different cause of late postpartum hemorrhage, which is less common than uterine atony. Retained placental fragments are pieces of placenta that remain atached to the uterine wall after delivery, which prevent uterine contraction and involution, and provide a source of bleeding and infection. Retained placental fragments can be caused by abnormal placentation (such as placenta accreta), manual removal of placenta, or incomplete separation of placenta.

Choice B Reason: Cervical or vaginal lacerations. This is an incorrect answer that refers to a different cause of late postpartum hemorrhage, which is more likely to cause early postpartum hemorrhage than late postpartum hemorrhage. Cervical or vaginal lacerations are tears or cuts in the cervix or vagina that occur during delivery, which can cause bleeding from the damaged blood vessels. Cervical or vaginal lacerations can be caused by rapid or instrumental delivery, large or malpositioned fetus, or episiotomy.

Choice C Reason: Uterine inversion. This is an incorrect answer that refers to a different cause of late postpartum hemorrhage, which is rare and life-threatening. Uterine inversion is a condition where the uterus turns inside out and protrudes through the cervix and vagina after delivery, which can cause massive bleeding and shock. Uterine inversion can be caused by excessive traction on the umbilical cord, fundal pressure, or uterine relaxation.

Choice D Reason: Uterine atony. This is because uterine atony is a condition where the uterus fails to contract and retract after delivery, which leads to bleeding from the placental site. Uterine atony is the most common cause of late postpartum hemorrhage, accounting for about 75% of cases. Late postpartum hemorrhage is excessive bleeding from the uterus or genital tract that occurs more than 24 hours but less than 12 weeks after delivery. Late postpartum hemorrhage can be caused by retained placental fragments, subinvolution of the uterus, infection, or coagulation disorders.