Page 876 - Saunders Comprehensive Review For NCLEX-RN

used for preeclamptic clients to prevent seizures decreased urine output, pulmonary administration
edema, serum magnesium levels
> 7.5 mEq/L (3.75 mmol/L)
Fetus—hypotonia and sleepiness Follow agency
protocol for
administration
Discontinue infusion
and notify OB if
adverse effects occur
Monitor for
respirations
< 12/min, urine
output < 100 mL/4 hr
(25-30 mL/hr)
Monitor DTRs
Monitor magnesium
levels and report
values outside
therapeutic range of
4 to 7.5 mEq/L (2 to
3.75 mmol/L)
Keep calcium
gluconate readily
accessible (antidote)
Nifedipine-calcium channel blocker; relaxes Maternal—tachycardia, hypotension, Follow agency
smooth muscles, including the uterus, by blocking dizziness, headache, nervousness, protocol for
calcium entry; in some health care agencies, this facial flushing, fatigue, nausea administration
may be the first-line agent to halt preterm labor Fetus—May cause vascular dilation Use with magnesium
contractions sulfate is avoided
because severe
hypotension can
occur
Monitor for adverse
effects
DTRs, Deep tendon reflexes; OB, obstetrician.

Table 28-2

Assessing Deep Tendon Reflexes

Grade Deep Tendon Reflex Response
0 No response
1 Sluggish or diminished
2 Active or expected response
3 More brisk than expected, slightly hyperactive
4 Brisk, hyperactive, with intermittent or transient clonus

Data from Seidel H, Ball J, Dains J, Flynn J, Solomon B, Stewart R: Mosby’s guide to
physical examination, ed 6, St. Louis, 2011, Mosby.

Box 28-1

Prostaglandins

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