A woman is receiving magnesium sulfate as part of her treatment for severe preeclampsia. The nurse is monitoring the woman's serum magnesium levels. The nurse determines that the drug is at a therapeutic level based on which result?
8.4 mEq/L
6.1 mEq/L
10.8 mEq/L
3.3 mEq/L
The Correct Answer is B
A. 8.4 mEq/L is above the therapeutic range and may indicate magnesium toxicity. Levels greater than 7.5–8 mEq/L can lead to loss of deep tendon reflexes, and higher levels can cause respiratory depression and cardiac arrest.
B. 6.1 mEq/L falls within the therapeutic range for magnesium sulfate when used to treat severe preeclampsia, which is generally 4.8–8.4 mEq/L (or 4–7 mEq/L depending on the source and unit of measurement). This level is considered safe and effective for preventing seizures.
C. 10.8 mEq/L is too high and indicates magnesium toxicity, placing the patient at risk for serious complications like respiratory or cardiac arrest.
D. 3.3 mEq/L is below the therapeutic range, suggesting that the dose may be inadequate to prevent eclamptic seizures in a woman with severe preeclampsia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Ferning is a test to detect ferning patterns in amniotic fluid under a microscope. A positive result indicates the presence of amniotic fluid but does not suggest infection.
B. Yellow-green fluid may suggest meconium-stained amniotic fluid, which is often associated with fetal distress, but it does not directly indicate infection. However, it can increase the risk of infection if the meconium is aspirated by the baby.
C. Foul odor is a key sign that infection may be present, particularly in the case of chorioamnionitis, an infection of the fetal membranes. A foul odor in the amniotic fluid suggests the presence of bacteria and should raise concern for infection, requiring prompt intervention.
D. Blue color on Nitrazine testing indicates that the amniotic fluid is alkaline, which is expected and normal, as amniotic fluid typically has a pH of 7-7.5. This test is used to confirm the rupture of membranes, not infection.
Correct Answer is C
Explanation
A. Oligohydramnios is more commonly associated with conditions like fetal growth restriction or placental insufficiency, and it is less common in twin pregnancies, which are actually more prone to polyhydramnios, especially in cases of twin-to-twin transfusion syndrome.
B. Chorioamnionitis is an infection of the fetal membranes, which can occur in any pregnancy, particularly with prolonged rupture of membranes, but it is not uniquely or especially linked to twin pregnancies.
C. Preeclampsia is correct. Women carrying twins (or other multiples) are at significantly higher risk for developing preeclampsia due to the increased placental mass and associated vascular demands. Nurses should be particularly vigilant in monitoring for signs like elevated blood pressure, proteinuria, edema, and headaches in these clients.
D. Post-term labor is less likely in twin pregnancies, as multiples are more often born preterm, not post-term, due to uterine overdistension and other complications.
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