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NURS 501 Labor and Delivery Case Study Cindy

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Cindy, a 17 year-old G1P0 is admitted to the labor and delivery unit for an induction at 38 weeks gestation. She was diagnosed with preeclampsia at 34 weeks gestation. She has been on strict bed res... t for the past 4 weeks. She has been doing daily fetal kick counts and had a BPP done 2 days ago which was normal. She has been placed on an external fetal monitor and FHT’s are 125-135 with accelerations noted. The external contraction monitor shows no contractions and Cindy denies feeling any contractions. A vaginal exam is done and she is 2 cm dilated, 75% effaced and the fetus is at a 0 station. An IV of LR has been started in her left forearm and is running at 75ml/hr. The physician has prescribed MgSO4 and has ordered initial admission labs: CBC, Type and Cross and a Liver Profile now and a MgSO4 level to be drawn in 2 hours. The time is now 0800. 1. What is the normal loading dose for MgSO4? Normal loading dose for magnesium sulfate is 4-6 grams over 15 minutes, to be followed by a maintenance dose of 1-2 grams per hour, continuous, until desired outcome is reached. What assessments should the nurse perform related to the administration of MgSO4 and potential side effects? Nursing assessments of maternal vital signs, FHR, monitor urine output for amount and presence of proteinuria. Magnesium sulfate could lead to magnesium toxicity in pregnant body, fetus or infant: respiratory depression, paralysis, HR changes, stupor, CNS depression (loss of DTRs), blurred vision, tetany (antidote to respiratory or cardiac arrest is calcium gluconate). ( Perry, et al., 2018, p. 291) Why is Cindy receiving this medic [Show More]

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