. nurse is assisting with the care of a client with PROM and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

Heart rate of 55/min

Urine output of 50 mL in 4 hr

Diminished deep-tendon reflexes

Respiratory rate of 16/min

Answer and Explanation

The Correct Answer is D

A. Heart rate of 55/min. A heart rate of 55/min is bradycardia, which may indicate magnesium toxicity. This is a concerning sign and does not indicate safety to continue.

B. Urine output of 50 mL in 4 hr. A urine output of only 50 mL in 4 hours is too low (less than 30 mL/hr is concerning) and may indicate toxicity, since magnesium sulfate is excreted via the kidneys.

C. Diminished deep-tendon reflexes. Diminished deep-tendon reflexes (DTRs) may indicate magnesium toxicity. DTRs are monitored to assess for toxicity.

D. Respiratory rate of 16/min. A normal respiratory rate (12-20 breaths per minute) indicates that the magnesium sulfate has not caused respiratory depression, a sign of magnesium toxicity.

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Correct Answer is D

Explanation

A. "Count the fetal heart rate for 15 seconds to determine the baseline." The fetal heart rate (FHR) should be counted for a full minute to determine the baseline, not just for 15 seconds.

B. "Auscultate the fetal heart rate every 5 minutes during the active phase of the first stage of labor." The fetal heart rate is typically auscultated every 30 minutes in low-risk clients during the first stage of labor.

C. "Auscultate the fetal heart rate every 30 minutes during the second stage of labor." The fetal heart rate should be auscultated every 15 minutes during the second stage of labor, not every 30 minutes.

D. "Count the fetal heart rate after a contraction to determine baseline changes." It is important to assess the fetal heart rate after a contraction to determine if there are any decelerations or baseline changes that may indicate fetal distress.

A. Bloody show from the vagina B. Early decelerations in the FHR C. Uterine contraction lasting 2 min D. Pelvic pressure with contractions

Correct Answer is C

Explanation

A. Bloody show from the vagina: Bloody show is a normal sign during the second stage of labor, indicating that the cervix is dilating and the labor is progressing. It does not require immediate reporting.

B. Early decelerations in the FHR: Early decelerations are often a benign finding during labor, typically caused by head compression and do not usually indicate distress.

C. Uterine contraction lasting 2 minutes: A uterine contraction lasting 2 minutes is considered prolonged, and this can lead to decreased blood flow to the fetus, resulting in fetal distress. The provider should be notified.

D. Pelvic pressure with contractions: Pelvic pressure is a normal part of the second stage of labor as the fetus descends into the birth canal. This is an expected finding and does not require immediate reporting.

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. nurse is assisting with the care of a client with PROM and is receiving magnesium sulfate IV at 2 g/hr. Which of the following findings indicates that it is safe for the nurse to continue the infusion?

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