Intrapartum Management
Intrapartum Management ( 5 Questions)
A nurse is caring for a client with pre-eclampsia who is receiving magnesium sulfate intravenously.
Which of the following assessments is the most important for the nurse to monitor?
Blood pressure is a major sign of preeclampsia, but it is not the most important assessment to monitor when receiving magnesium sulfate therapy. Blood pressure may be controlled by other antihypertensive medications.
Deep tendon reflexes are important to monitor because they indicate the level of neuromuscular irritability caused by magnesium sulfate therapy. Magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia. A healthcare provider will give the medication intravenously. If the deep tendon reflexes are absent or diminished, it may indicate magnesium toxicity, which can cause respiratory depression, cardiac arrest, and coma.
Normal ranges:
• Blood pressure: less than 140/90 mm Hg
• Deep tendon reflexes: 2+ (normal) or 3+ (brisk) on a scale of 0 to 4
• Fetal heart rate: 110 to 160 beats per minute
• Urine output: at least 30 mL per hour
Fetal heart rate is important to monitor for fetal well-being, but it is not directly affected by magnesium sulfate therapy. Fetal heart rate may be monitored by nonstress test or biophysical profile.
Urine output is important to monitor for kidney function, but it is not the most important assessment to monitor when receiving magnesium sulfate therapy. Urine output may be measured by urine analysis or 24-hour urine sample.
Deep tendon reflexes are important to monitor because they indicate the level of neuromuscular irritability caused by magnesium sulfate therapy. Magnesium sulfate is a mineral that reduces seizure risks in women with preeclampsia. A healthcare provider will give the medication intravenously. If the deep tendon reflexes are absent or diminished, it may indicate magnesium toxicity, which can cause respiratory depression, cardiac arrest, and coma.
Other statement options:
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A. Blood pressure: Blood pressure is a major sign of preeclampsia, but it is not the most important assessment to monitor when receiving magnesium sulfate therapy. Blood pressure may be controlled by other antihypertensive medications.
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C. Fetal heart rate: Fetal heart rate is important to monitor for fetal well-being, but it is not directly affected by magnesium sulfate therapy. Fetal heart rate may be monitored by nonstress test or biophysical profile.
•
D. Urine output: Urine output is important to monitor for kidney function, but it is not the most important assessment to monitor when receiving magnesium sulfate therapy. Urine output may be measured by urine analysis or 24-hour urine sample.
Normal ranges:
• Blood pressure: less than 140/90 mm Hg
• Deep tendon reflexes: 2+ (normal) or 3+ (brisk) on a scale of 0 to 4
• Fetal heart rate: 110 to 160 beats per minute
• Urine output: at least 30 mL per hour