Cindy, a 17-year-old G1P0, is admitted to the labor and delivery unit for induction at 38 weeks gestation. She was diagnosed with preeclampsia at 34 weeks gestation and has been on strict bed rest for the past 4 weeks. She has been performing daily fetal kick counts, and a BPP conducted 2 days ago was normal. Currently, she is on an external fetal monitor showing FHT’s at 125-135 with noted accelerations. The external contraction monitor shows no contractions, and Cindy denies feeling any contractions. A vaginal exam reveals 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, running at 75 ml/hr. The physician has prescribed MgSO₄ and ordered initial admission labs: CBC, Type and Cross, and a Liver Profile, with a MgSO₄ level to be drawn in 2 hours. The time is now 0800.

Questions:
1. What is the normal loading dose for MgSO₄?
2. What assessments should the nurse perform related to the administration of MgSO₄ and potential side effects?
3. Why is Cindy receiving this medication?

Question

28-12-2023
Medicine

College

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Cindy, a 17-year-old G1P0, is admitted to the labor and delivery unit for induction at 38 weeks gestation. She was diagnosed with preeclampsia at 34 weeks gestation and has been on strict bed rest for the past 4 weeks. She has been performing daily fetal kick counts, and a BPP conducted 2 days ago was normal. Currently, she is on an external fetal monitor showing FHT’s at 125-135 with noted accelerations. The external contraction monitor shows no contractions, and Cindy denies feeling any contractions. A vaginal exam reveals 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, running at 75 ml/hr. The physician has prescribed MgSO₄ and ordered initial admission labs: CBC, Type and Cross, and a Liver Profile, with a MgSO₄ level to be drawn in 2 hours. The time is now 0800.

Questions:
1. What is the normal loading dose for MgSO₄?
2. What assessments should the nurse perform related to the administration of MgSO₄ and potential side effects?
3. Why is Cindy receiving this medication?

Answer :

Final answer:

The initial loading dose for MgSO₄ is typically 4-6 grams. Nurses should monitor vital signs, reflexes, respiratory rate, urine output, and serum magnesium levels to detect any toxicity. MgSO₄ is used in this case to prevent seizures due to severe preeclampsia.

Explanation:

Cindy is receiving magnesium sulfate (MgSO₄) to prevent seizures, a common complication in severe preeclampsia. The usual initial loading dose of MgSO₄ is 4-6 grams given over 15-30 minutes intravenously. After the loading dose, a continuous infusion is typically maintained at a rate of 1-2 grams per hour.

When MgSO₄ is administered, it is crucial that nurses perform regular assessments. These include checking Cindy's vital signs, patellar reflexes, respiratory rate, urine output, and serum magnesium levels. Signs of MgSO₄ toxicity can include the loss of reflexes, respiratory depression (<12 breaths per minute), altered level of consciousness, and urine output of <30ml/hr.

MgSO₄ can also cause flushing, sweating, and a feeling of warmth, so it is pertinent to help comfort her through these side effects.

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