The healthcare provider prescribes a maintenance dose of magnesium sulfate 2 grams per hour intravenously (IV) for a client with preeclampsia.

The IV bag contains magnesium sulfate 20 grams in dextrose 5% in water 500 mL. How many mL/hour should the nurse program the infusion pump? (Enter numerical value only)

Choice A rationale

Increasing IV fluids is a critical intervention to maintain maternal hemodynamic stability and prevent complications related to fluid imbalance. It helps support blood pressure and overall fluid status during labor and delivery.

Choice B rationale

While obtaining blood pressure is important for monitoring maternal status, it is not an immediate intervention compared to others listed. Blood pressure monitoring is part of routine assessment but not an emergency action.

Choice C rationale

Stopping the infusion of magnesium is essential if there are signs of magnesium toxicity or adverse effects. Magnesium can impact respiratory and cardiac function, so stopping the infusion is a priority.

Choice D rationale

Administering oxygen is an immediate intervention to ensure adequate oxygenation for both the mother and the fetus. It is crucial during labor and delivery to prevent hypoxia and related complications.

Choice E rationale

Obtaining serum magnesium level is necessary to assess for magnesium toxicity and guide further interventions. It provides important information on the mother's magnesium status and helps in making clinical decisions.

Choice F rationale

Preparing for a cesarean delivery is not an immediate intervention unless there are specific indications for surgical delivery. It should be based on clinical findings and maternal-fetal status.

Choice G rationale

Administering calcium gluconate is the antidote for magnesium toxicity and is an immediate intervention if signs of toxicity are present. It helps counteract the effects of excessive magnesium.

Choice H rationale

Preparing to prevent respiratory or cardiac arrest is a critical intervention in severe cases of magnesium toxicity, but it should be part of a broader emergency management plan rather than an immediate action. .

Choice A rationale

Monitoring hourly blood pressure is essential, but it is not the most crucial data in this scenario. Blood pressure monitoring can help identify maternal hypotension or hypertension, which can affect uteroplacental blood flow. However, hypotonic dystocia requires monitoring contractions to assess labor progression and effectiveness of oxytocin.

Choice B rationale

Preparing for an emergency cesarean birth is a potential intervention if labor does not progress or if fetal distress occurs. However, it is not the primary data to monitor initially. The decision for a cesarean is based on a comprehensive assessment, including fetal heart rate patterns and contraction quality.

Choice C rationale

Checking the perineum for bulging may indicate imminent delivery or fetal descent. However, in the context of hypotonic dystocia, the primary concern is evaluating contraction patterns to ensure the effectiveness of oxytocin in augmenting labor.

Choice D rationale

Monitoring the intensity, interval, and length of contractions is the most critical data in this case. Hypotonic dystocia involves weak, infrequent, or irregular contractions. Oxytocin is administered to strengthen and regularize contractions, so assessing their characteristics is crucial to determine the response to treatment and guide further interventions.