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

A weight gain of 2 pounds (0.91 kg) in a 34-week gestation multigravida is generally considered normal. During the third trimester, it is typical for a pregnant woman to gain around 0.5 to 1 pound per week. This weight gain helps support the growing fetus and prepare the mother's body for labor and breastfeeding. However, sudden or excessive weight gain could indicate fluid retention or preeclampsia, but a 2-pound gain alone is not necessarily a concern.

Choice B rationale

1+ edema on the lower extremities is a common finding during pregnancy, especially in the later stages. It is usually due to increased blood volume and pressure on the pelvic veins from the growing uterus, which can slow the return of blood from the legs. While some degree of edema is normal, particularly in the ankles and feet, it is important to monitor for sudden or severe swelling, which could be a sign of preeclampsia.

Choice C rationale

A fundal height of 30 cm at 34 weeks gestation is concerning because it is less than the expected measurement. Fundal height typically corresponds to gestational age in centimeters (±2 cm). Therefore, at 34 weeks, the expected fundal height would be between 32 and 36 cm. A smaller fundal height could indicate intrauterine growth restriction (IUGR), oligohydramnios, or other fetal development issues, which require further evaluation by the healthcare provider.

Choice D rationale

A fetal heart rate (FHR) of 110 beats per minute (bpm) is within the normal range for a fetus. The normal FHR typically ranges from 110 to 160 bpm. Although 110 bpm is on the lower end of the normal range, it is still considered acceptable. Significant deviations from the normal range, either too low (bradycardia) or too high (tachycardia), could indicate fetal distress and require immediate attention.

Choice A rationale

Reporting the findings immediately to the healthcare provider is crucial in this scenario. Intense testicular pain with erythema and swelling can indicate testicular torsion, which is a medical emergency requiring prompt surgical intervention to preserve testicular function. Delays in treatment can result in loss of the affected testicle.

Choice B rationale

Obtaining a swab of secretions from the penis and urethra is not the immediate priority in this situation. While it can be important for diagnosing infections, the acute nature of the symptoms suggests a more urgent condition, such as testicular torsion, which needs immediate attention from a healthcare provider.

Choice C rationale

Providing the adolescent with a urinal for urinary hesitancy does not address the immediate concern of intense pain and significant swelling. The symptoms suggest a possible emergency, and addressing urinary hesitancy can wait until after more urgent conditions are ruled out or treated.

Choice D rationale

Collecting a sterile urine sample for culture and sensitivity is not the immediate priority. While it might be useful for diagnosing infections, the symptoms of intense pain, erythema, and swelling in the testicular area suggest an urgent condition like testicular torsion, which requires immediate evaluation and treatment.