A woman with severe preeclampsia is receiving a magnesium sulfate infusion. The nurse becomes concerned after assessment when the woman exhibits:

Choice A reason: Raising the woman's legs is not the best initial response, as it may worsen the dizziness and light-headedness. This is because raising the legs can increase the blood flow to the lower extremities and decrease the blood flow to the brain, which can cause hypotension (low blood pressure) and hypoxia (low oxygen) in the woman and the fetus.

Choice B reason: Having the woman breathe into a paper bag is not the best initial response, as it may not address the underlying cause of the dizziness and light-headedness. This technique is usually used for hyperventilation (rapid breathing), which can cause respiratory alkalosis (high blood pH) and reduce the carbon dioxide levels in the blood. However, the woman may not be hyperventilating, but rather experiencing supine hypotensive syndrome (low blood pressure when lying on the back) due to the pressure of the uterus on the inferior vena cava (a large vein that returns blood to the heart)².

Choice C reason: Turning the woman on her side is the best initial response, as it can relieve the dizziness and light-headedness by improving the blood flow to the brain and the fetus. This is because turning the woman on her side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output (the amount of blood pumped by the heart) and the blood pressure. The left lateral position is preferred, as it can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.

Choice D reason: Assessing the woman's blood pressure and pulse is an important response, but not the first one. After turning the woman on her side, the nurse should monitor the vital signs and the fetal heart rate to evaluate the condition of the woman and the fetus. The nurse should also check for other signs and symptoms of supine hypotensive syndrome, such as nausea, sweating, and visual disturbances.

Choice A reason: Pointing out that inappropriate sexual behavior caused the infection is not helpful, as it may make the woman feel guilty, ashamed, or defensive. The nurse should avoid blaming or judging the woman and focus on providing education and support.

Choice B reason:Positioning the patient in asemi-Fowler position(head of the bed elevated 30–45 degrees) helps promote drainage of pelvic exudate and reduces the risk of abscess formation or further spread of infection. This is a key nursing intervention for patients withacute pelvic inflammatory disease (PID).

Choice C reason: Telling her that antibiotics need to be taken until pelvic pain is relieved is incorrect, as it may lead to incomplete treatment and recurrence of the infection. The nurse should instruct the woman to take the full course of antibiotics as prescribed, regardless of the symptoms.

Choice D reason:While infertility is apotential complicationof PID, it is not a guaranteed outcome. The nurse should provideaccurate informationabout risks but avoid causing unnecessary alarm. The focus should be onprompt treatment and prevention of complications.