Maryland Next Gen NCLEX Test Bank Project
September 1, 2022
Case Study Topic: (& stand-alone bow-tie)Pre-Eclampsia with magnesium toxicityAuthor
:Christine Schlaerth, PhD, RN, CNM, WHNP-BC
Carroll Community College
Case Summary
A client diagnosed with preeclampsia is admitted at 35 weeks gestation to labor and delivery. Magnesium sulfate is administered for seizure prophylaxis, and magnesium toxicity develops. Learner should recognize s/s of magnesium toxicity and implement appropriate nursing interventions.
Objectives 1.Recognize s/s magnesium toxicity
2.Recognize trends and changes in client conditions/vital signs and intervene as needed 3.Provide care for clients experiencing complications of pregnancy/labor and or delivery 4.Evaluate and document actions taken to counteract side effects of medications and parenteral therapies
Case Study Link Case Study QR Code
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Bow-tie QR Code Bow-tie Link
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Case References
1.Agency for Healthcare Research and Quality (2017). Safe medication administration: Magnesium sulfate. Retrieved from: https://www.ahrq.gov/hai/tools/perinatal-
care/modules/strategies/medication/tool-safe-mgso4.html
2.Bristol, T.J., Herrman, J.W, and Stephenson, W. (2019). Hypertensive Disorders of Pregnancy. In
NurseThink for Students: NCLEX-RN Conceptual Review Guide (pp. 46). NurseTim, Inc.
CJCST Version 2.1 designed by Desirée Hensel, 2022. Permission granted to use and modify template for educational purposes. Case Study Question 1 of 6 The nurse is caring for a client admitted to the labor and delivery unit at 35 weeks gestation with preeclampsia.
Click to highlight the 4 findings that are most significant. Admission Note
0845. Client is a 29-year-old primigravida at 35 weeks gestation admitted with severe preeclampsia. Plan is magnesium sulfate x 24 hours, followed by induction of labor.
Flowsheet
Time 0900100011001200
Magnesium sulfate dose 4g2g2g2g
Reflexes present Yes +2Yes +2Yes +2No
Blood pressure 159/89 139/84131/85109/72
Heart rate 727172102
Respirations 18181711
Pulse oximetry 99% on RA99% on RA98% on RA92% on RA
Urine Output 35ml30ml30ml20ml
Other drugs or observationsNoneNauseaNausea, cutaneous flushing, sweating Shortness of breath
0900. 4g loading dose magnesium sulfate IV started, to be run over 20 minutes. Second nurse verified pump settings. Client educated on medication side effects. Client complains of headache rated 7/10, no nausea/vomiting, no epigastric pain, no visual disturbances. Current BP 159/89. Fetal monitor shows baseline heart rate 130 bpm, moderate variability, accelerations present, decelerations absent. 0920. Magnesium sulfate loading dose complete. Magnesium rate rate changed to 2g/hr continuous infusions. Second nurse verified pump settings.
1100. Client noted to have cutaneous flushing and sweating. Fan brought to bedside.
1200. Absent patellar reflex, RR 11, with complaints of shortness of breath. Pulse oximeter 92% on RA.
Key
Flowsheet
Time 0900100011001200
Magnesium sulfate dose 4g2g2g2g
Reflexes present Yes +2Yes +2Yes +2No
Blood pressure 159/89 139/84131/85109/72
Heart rate 727172102
Respirations 18181711
Pulse oximetry 99% on RA99% on RA98% on RA92% on RA
Urine Output 35ml30ml30ml20ml
Other drugs or NoneNauseaNausea, Shortness of CJCST Version 2.1 designed by Desirée Hensel, 2022. Permission granted to use and modify template for educational purposes.
September 1, 2022
Case Study Topic: (& stand-alone bow-tie)Pre-Eclampsia with magnesium toxicityAuthor
:Christine Schlaerth, PhD, RN, CNM, WHNP-BC
Carroll Community College
Case Summary
A client diagnosed with preeclampsia is admitted at 35 weeks gestation to labor and delivery. Magnesium sulfate is administered for seizure prophylaxis, and magnesium toxicity develops. Learner should recognize s/s of magnesium toxicity and implement appropriate nursing interventions.
Objectives 1.Recognize s/s magnesium toxicity
2.Recognize trends and changes in client conditions/vital signs and intervene as needed 3.Provide care for clients experiencing complications of pregnancy/labor and or delivery 4.Evaluate and document actions taken to counteract side effects of medications and parenteral therapies
Case Study Link Case Study QR Code
https://umaryland.az1.qualtrics.com/jfe/form/
SV_eyabT2E95Uker4O
Bow-tie QR Code Bow-tie Link
https://umaryland.az1.qualtrics.com/jfe/form/
SV_5svaq0CHkK9aRT0
Case References
1.Agency for Healthcare Research and Quality (2017). Safe medication administration: Magnesium sulfate. Retrieved from: https://www.ahrq.gov/hai/tools/perinatal-
care/modules/strategies/medication/tool-safe-mgso4.html
2.Bristol, T.J., Herrman, J.W, and Stephenson, W. (2019). Hypertensive Disorders of Pregnancy. In
NurseThink for Students: NCLEX-RN Conceptual Review Guide (pp. 46). NurseTim, Inc.
CJCST Version 2.1 designed by Desirée Hensel, 2022. Permission granted to use and modify template for educational purposes. Case Study Question 1 of 6 The nurse is caring for a client admitted to the labor and delivery unit at 35 weeks gestation with preeclampsia.
Click to highlight the 4 findings that are most significant. Admission Note
0845. Client is a 29-year-old primigravida at 35 weeks gestation admitted with severe preeclampsia. Plan is magnesium sulfate x 24 hours, followed by induction of labor.
Flowsheet
Time 0900100011001200
Magnesium sulfate dose 4g2g2g2g
Reflexes present Yes +2Yes +2Yes +2No
Blood pressure 159/89 139/84131/85109/72
Heart rate 727172102
Respirations 18181711
Pulse oximetry 99% on RA99% on RA98% on RA92% on RA
Urine Output 35ml30ml30ml20ml
Other drugs or observationsNoneNauseaNausea, cutaneous flushing, sweating Shortness of breath
0900. 4g loading dose magnesium sulfate IV started, to be run over 20 minutes. Second nurse verified pump settings. Client educated on medication side effects. Client complains of headache rated 7/10, no nausea/vomiting, no epigastric pain, no visual disturbances. Current BP 159/89. Fetal monitor shows baseline heart rate 130 bpm, moderate variability, accelerations present, decelerations absent. 0920. Magnesium sulfate loading dose complete. Magnesium rate rate changed to 2g/hr continuous infusions. Second nurse verified pump settings.
1100. Client noted to have cutaneous flushing and sweating. Fan brought to bedside.
1200. Absent patellar reflex, RR 11, with complaints of shortness of breath. Pulse oximeter 92% on RA.
Key
Flowsheet
Time 0900100011001200
Magnesium sulfate dose 4g2g2g2g
Reflexes present Yes +2Yes +2Yes +2No
Blood pressure 159/89 139/84131/85109/72
Heart rate 727172102
Respirations 18181711
Pulse oximetry 99% on RA99% on RA98% on RA92% on RA
Urine Output 35ml30ml30ml20ml
Other drugs or NoneNauseaNausea, Shortness of CJCST Version 2.1 designed by Desirée Hensel, 2022. Permission granted to use and modify template for educational purposes.
