When assessing a pregnant client with eclampsia who is receiving IV magnesium sulphate, which finding should the nurse report to the health care provider immediately?

A. “I should drink wine occasionally instead of every night”: Reducing alcohol consumption is appropriate since alcohol irritates the gastric mucosa and can worsen gastritis. Occasional, moderate intake may be tolerated, but complete avoidance is preferable during healing.

B. “I should decrease my intake of caffeinated drinks, especially coffee”: Caffeine stimulates gastric acid secretion, aggravating gastritis symptoms and delaying mucosal recovery. Recognizing the need to limit coffee and other caffeinated beverages demonstrates correct understanding of preventive self-care measures.

C. “I can continue smoking cigarettes which is better than chewing tobacco”: Smoking, regardless of form, impairs gastric mucosal blood flow and interferes with healing of gastritis. It also increases gastric acid secretion and delays epithelial repair.

D. “I will take acetaminophen instead of aspirin when I have a headache”: Aspirin is a known gastric irritant that can worsen gastritis and cause ulcer formation. Choosing acetaminophen, which has minimal gastric irritation, reflects correct understanding of medication safety.

A. Dyspepsia: Dyspepsia, or indigestion, is a common symptom associated with peptic ulcer disease rather than a complication. It often presents as epigastric discomfort, bloating, or nausea, which are expected findings in this condition and not indicative of worsening disease.

B. Upper gastrointestinal (GI) bleeding: Upper GI bleeding is the most significant and potentially life-threatening complication of peptic ulcer disease. It occurs when an ulcer erodes into a blood vessel, leading to hematemesis or melena.

C. Gastric cancer: Chronic peptic ulcer disease, especially those related to H. pylori infection, can increase the long-term risk of gastric cancer. However, cancer is a delayed sequela rather than an acute complication, so it is not the immediate priority for monitoring during hospitalization.

D. Large bowel obstruction: Large bowel obstruction is unrelated to peptic ulcer disease, as ulcers occur in the stomach or duodenum, not the large intestine. Monitoring for obstruction symptoms such as abdominal distention or absence of bowel movements would not be relevant to this client’s current diagnosis.