(select all that apply) A nurse is reviewing the laboratory results of a client with eclampsia who is receiving magnesium sulfate.

Which of the following values should the nurse report to the provider? (Select all that apply.)

Serum magnesium level of 8 mg/dL

Serum calcium level of 7 mg/dL

Serum creatinine level of 1.2 mg/dL

Serum potassium level of 3.8 mEq/L

Serum sodium level of 140 mEq/L

Answer and Explanation

Correct Answer : A,B

The correct answer is A and B. A. Serum magnesium level of 8 mg/dL

This statement is correct because a serum magnesium level of 8 mg/dL (6.6 mmol/L) is within the therapeutic range for eclampsia treatment, which is 3.5 to 7 mEq/L (4.2 to 8.4 mg/dL) according to some sources, or 1.5 to 3.5 mmol/L according to others. A serum magnesium level above 8 mEq/L (10 mmol/L) can cause areflexia, respiratory paralysis, and cardiac arrest.

B. Serum calcium level of 7 mg/dL

This statement is correct because a serum calcium level of 7 mg/dL (1.75 mmol/L) is below the normal range of 8.5 to 10.2 mg/dL (2.12 to 2.55 mmol/L), which indicates hypocalcemia. Hypocalcemia is a common side effect of magnesium sulfate therapy, as magnesium competes with calcium for binding sites on plasma proteins and cell membranes, and also inhibits the release of parathyroid hormone.

C. Serum creatinine level of 1.2 mg/dL

This statement is wrong because a serum creatinine level of 1.2 mg/dL (106 umol/L) is within the normal range of 0.6 to 1.3 mg/dL (53 to 115 umol/L) for women. Serum creatinine level reflects kidney function, and renal impairment can affect the clearance of magnesium sulfate and increase the risk of toxicity.

D. Serum potassium level of 3.8 mEq/L

This statement is wrong because a serum potassium level of 3.8 mEq/L (3.8 mmol/L) is within the normal range of 3.5 to 5 mEq/L (3.5 to 5 mmol/L) for adults. Serum potassium level reflects electrolyte balance, and hypokalemia or hyperkalemia can affect cardiac function and muscle contraction.

E. Serum sodium level of 140 mEq/L

This statement is wrong because a serum sodium level of 140 mEq/L (140 mmol/L) is within the normal range of 135 to 145 mEq/L (135 to 145 mmol/L) for adults. Serum sodium level reflects fluid balance, and hyponatremia or hypernatremia can affect brain function and blood pressure.

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Correct Answer is D

Explanation

The correct answer is d. Notify the health care provider.

Rationale for Choice A:

Increasing the rate of oxytocin infusion is contraindicated in this situation.
Oxytocin stimulates uterine contractions,and the client is already experiencing excessively frequent and prolonged contractions.
Increased oxytocin could further compromise uteroplacental blood flow and exacerbate fetal distress.
It could also put the client at higher risk for uterine rupture,a serious complication associated with oxytocin use.

Rationale for Choice B:

While administering oxygen is a common intervention for fetal distress,it's not the priority action in this case.
Late decelerations in fetal heart rate are typically caused by uteroplacental insufficiency,which means the fetus isn't receiving adequate oxygen and nutrients from the placenta.
Oxygen administered to the mother may not significantly improve fetal oxygenation if the underlying issue is impaired placental perfusion.

Rationale for Choice C:

Turning the client to her left side is a recommended position to improve placental blood flow.
However,in this situation,it's not the priority action given the presence of late decelerations and excessive uterine contractions.
It may be a helpful adjunct measure,but it won't address the primary cause of fetal distress.

Rationale for Choice D:

Notifying the health care provider is the most crucial action because:
- The client has severe pre-eclampsia,a serious condition that requires close monitoring and management.
- The frequent and prolonged contractions,along with late decelerations in the fetal heart rate,indicate potential fetal distress.
- The health care provider needs to be aware of these changes to make timely decisions regarding interventions,such as:
  - Adjusting the oxytocin infusion
  - Expediting delivery if necessary
  - Implementing other measures to improve fetal well-being
  - Closely monitoring the mother's condition to prevent complications of pre-eclampsia

A. Serum creatinine of 1.2 mg/dL B. Liver enzymes of 40 U/L C. Platelet count of 100,000/mm3 D. Coagulation profile of 12 seconds E. Urine output of 20 mL/hour

Correct Answer is ["C","E"]

Explanation

The correct answer is choice C and E.A platelet count of 100,000/mm3 is low and indicates a risk of bleeding due to preeclampsia.A urine output of 20 mL/hour is also low and suggests kidney impairment due to magnesium sulfate therapy.

Both of these results should be reported to the provider as they may require intervention.

Choice A is wrong because a serum creatinine of 1.2 mg/dL is within the normal range of 0.6 to 1.3 mg/dL for womenand does not indicate kidney dysfunction.

Choice B is wrong because liver enzymes of 40 U/L are within the normal range of 7 to 55 U/L for women and do not indicate liver damage.

Choice D is wrong because a coagulation profile of 12 seconds is within the normal range of 11 to 13.5 seconds for women and does not indicate a clotting disorder.

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(select all that apply) A nurse is reviewing the laboratory results of a client with eclampsia who is receiving magnesium sulfate. Which of the following values should the nurse report to the provider? (Select all that apply.)

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client with severe pre-eclampsia who is being induced with oxytocin. The nurse notes that the client’s contractions are occurring every 2 minutes and lasting 90 seconds. The fetal heart rate is 160 beats/minute with late decelerations. What is the priority nursing action?

Correct Answer is D

Explanation

A nurse is reviewing the laboratory results of a client with severe pre-eclampsia who is receiving magnesium sulfate intravenously. Which of the following results should the nurse notify the provider about? (Select all that apply.)

Correct Answer is ["C","E"]

Explanation

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(select all that apply) A nurse is reviewing the laboratory results of a client with eclampsia who is receiving magnesium sulfate.

Which of the following values should the nurse report to the provider? (Select all that apply.)