The nurse is caring for a client who is being treated with Magnesium Sulphate.

Ordered 2g/hr

Supplied 10g/250ml bag

What would be the correct calculations for the maintenance dose in ml/hr

A. "Let me check your vaginal discharge just to make sure everything is fine." While it's important to monitor for abnormal discharge (such as signs of infection or retained placental tissue), this response does not address the cause of the contractions, which are a normal postpartum occurrence.

B. "Your body is responding to the events of labor, just like after a tough workout." This statement doesn't accurately explain the specific cause of the contractions, which are related to hormonal changes after childbirth rather than residual effects of labor itself.

C. "Your uterus is still shrinking in size; that's why you're feeling this pain." While it’s true that the uterus is shrinking (involution), the primary reason for the contraction-like pain is the release of oxytocin during breastfeeding, not simply the shrinking of the uterus.

D. "The baby's sucking releases a hormone that causes the uterus to contract." This is the correct answer. When a newborn suckles at the breast, it stimulates the release of oxytocin, a hormone that causes the uterus to contract. These contractions are known as "afterpains" and are more common in women who have had multiple pregnancies. They help the uterus return to its normal size after delivery.

A. "This is meconium stool and is normal for a newborn." is the correct and most appropriate response. Meconium is the newborn’s first stool, typically passed within the first 24 to 48 hours of life. It is black, tarry, and sticky in appearance and consists of materials the baby ingested while in the womb, such as amniotic fluid, mucus, and cells. It is completely normal and expected.

B. "You probably took iron during your pregnancy and that is what causes this type of stool." is incorrect. While iron supplements can darken adult stools, meconium is unrelated to maternal iron intake and is a normal physiological occurrence in all newborns.

C. “This is unusual, and I need to report this to your pediatrician." is incorrect and would be alarming to the parent unnecessarily. This is a normal finding, not something requiring physician notification.

D. "I'll take a sample and check it for possible bleeding" is also inappropriate unless there are other signs of concern (e.g., blood in stool later on). Meconium is not indicative of bleeding and does not warrant testing under normal circumstances.