Maternity Nursing: Antepartum Q 15

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A woman with preeclampsia is receiving magnesium sulfate. The nurse assigned to care for the client determines that the magnesium therapy is effective if:

  

     A. Ankle clonus is noted.

     B. The blood pressure decreases.

     C. Seizures do not occur.

     D. Scotomas are present.

    

    

Correct Answer: C. Seizures do not occur.

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For a client with preeclampsia, the goal of care is directed at preventing eclampsia (seizures). Seizures were a half or a third less likely to recur after treatment with magnesium. Maternal mortality was also lower in women allocated magnesium rather than phenytoin or diazepam, although this did not achieve statistical significance. Recent Cochrane reviews, however, indicated a significant reduction in maternal mortality with magnesium.

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Option A: Ankle clonus indicated hyperreflexia and may precede the onset of eclampsia. Although brisk or hyperactive reflexes are common during pregnancy, clonus is a sign of neuromuscular irritability that usually reflects severe preeclampsia.

Option B: Magnesium sulfate is an anticonvulsant, not an antihypertensive agent. Although a decrease in blood pressure may be noted initially, this effect is usually transient.

Option D: Scotomas are areas of complete or partial blindness. Visual disturbances, such as scotomas, often precede an eclamptic seizure.

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