Intrapartum Management
Intrapartum Management ( 5 Questions)
A client with eclampsia has a seizure during labor.
Which of the following actions should the nurse take first?
Turning the client to the side will prevent aspiration and maintain a patent airway, which is the priority intervention for a client who has a seizure.
Oxygen administration alone will not prevent aspiration or ensure a patent airway. Oxygen may be given after turning the client to the side and assessing the respiratory status.
Magnesium sulfate is used to prevent seizures in clients with eclampsia, not to treat them once they occur. Magnesium sulfate may be given after stabilizing the client and checking the serum magnesium level, which should be between 4 to 7 mg/dL (3.3 to 5.8 mEq/L) for therapeutic effect.
Documentation is important but not urgent in this situation. The nurse should document the seizure after providing immediate care and notifying the provider.
Turn the client to the side. This is because turning the client to the side will prevent aspiration and maintain a patent airway, which is the priority intervention for a client who has a seizure.
Some possible explanations for the other choices are:
• Choice B. Administer oxygen via face mask.
This is not the first action because oxygen administration alone will not prevent aspiration or ensure a patent airway. Oxygen may be given after turning the client to the side and assessing the respiratory status.
• Choice C. Give additional magnesium sulfate.
This is not the first action because magnesium sulfate is used to prevent seizures in clients with eclampsia, not to treat them once they occur. Magnesium sulfate may be given after stabilizing the client and checking the serum magnesium level, which should be between 4 to 7 mg/dL (3.3 to 5.8 mEq/L) for therapeutic effect.
• Choice D. Document the duration and characteristics of the seizure.
This is not the first action because documentation is important but not urgent in this situation. The nurse should document the seizure after providing immediate care and notifying the provider.