The healthcare provider prescribes magnesium sulfate 6 grams IV to be infused over 20 minutes for a client with preterm labor.

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

Choice A rationale

The client has a hemoglobin level of 12 g/dL and a hematocrit of 34%, which are within normal ranges for a postpartum woman. A blood transfusion is typically indicated for severe anemia or significant blood loss, neither of which is suggested by these lab results. Therefore, a blood transfusion is not warranted in this case.

Choice B rationale

Rubella vaccination is indicated for a client who is non-immune to rubella, as indicated by the laboratory results. Rubella vaccination is important to protect the client from contracting rubella in future pregnancies, which can cause serious congenital defects. Since the client is not currently pregnant and not immune, vaccination can be safely administered postpartum to prevent future rubella infections.

Choice C rationale

Penicillin G potassium is an antibiotic that might be used for a client who is group B Streptococcus positive to prevent neonatal infection during delivery. However, this client is group B Streptococcus negative, so there is no indication for this antibiotic. There is no need to administer Penicillin G potassium in this scenario.

Choice D rationale

Hepatitis B immunoglobulin is used for newborns of mothers who are hepatitis B surface antigen positive to prevent perinatal transmission of the virus. Since the client's lab results indicate she is hepatitis B surface antigen negative, there is no need for Hepatitis B immunoglobulin. The client and her newborn are not at risk of hepatitis B transmission, so this intervention is not required. .

Choice A rationale

While increasing protein intake is beneficial for overall health and pregnancy, it is not the primary factor that affects hemoglobin and hematocrit levels. These levels are more directly influenced by iron intake and the physiological changes during pregnancy. Protein intake is important for fetal growth and development, but it does not significantly alter the concentration of hemoglobin or hematocrit in the blood.

Choice B rationale

During pregnancy, plasma volume increases by approximately 50%, leading to hemodilution. This means that even though the total number of red blood cells increases, the concentration of hemoglobin and hematocrit appears lower due to the larger volume of plasma. This physiological change helps meet the increased oxygen demands of both the mother and the growing fetus and is a normal part of pregnancy.

Choice C rationale

Taking an iron supplement can help improve hemoglobin and hematocrit levels, especially if a pregnant woman has iron-deficiency anemia. Iron is essential for the production of hemoglobin, which carries oxygen in the blood. However, not all pregnant women with lower hemoglobin and hematocrit levels need to take iron supplements, as these values can be within the expected range for pregnancy. The decision to supplement should be based on individual assessment by a healthcare provider.

Choice D rationale

Not all women at 28 weeks gestation have anemia. While it is common for hemoglobin and hematocrit levels to be lower during pregnancy due to increased plasma volume, it does not mean that all pregnant women are anemic. Anemia is diagnosed based on specific thresholds for hemoglobin and hematocrit levels, and the values mentioned (hemoglobin 10.7 g/dL and hematocrit 32%) are borderline and may not necessarily indicate anemia.