The nurse in the postpartum unit is caring for a 26-year-old female client.
0400:Vaginal birth 6 hours ago. Preeclampsia with severe features; magnesium sulfate infusing by pump. Awake and talking. Patellar reflexes 2+. Lungs clear. Fundus firm and midline at the umbilicus; lochia rubra, pad lightly stained. Urine output 110 mL in total over the past 2 hours.
0600:Drowsy, opens eyes to voice, speech slow. Face flushed. Patellar reflexes absent in both legs. Lungs clear. Fundus firm and midline at the umbilicus; lochia rubra, pad lightly stained. Urine output 30 mL in total over the past 2 hours. No seizure activity. No opioid given since the birth.
The nurse is reviewing the client's assessment data to prepare the client's plan of care.
Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.
Action to TakeAction to Take
Condition Most Likely ExperiencingParameter to MonitorParameter to Monitor
Actions to Take
Massage the uterine fundus.
Request a magnesium sulfate bolus.
Stop the magnesium sulfate infusion.
Give calcium gluconate IV as prescribed.
Request a prescription for IV furosemide.
Potential Conditions
eclampsia
pulmonary edema
magnesium toxicity
postpartum hemorrhage
Parameters to Monitor
daily weight
urine protein
respiratory rate
patellar reflexes
crackles in the lungs