Question

TA (gravida 3, para 0) has a history of spontaneous abortion at 10 weeks gestation and a preterm delivery and demise of a neonate at 21 weeks gestation. At her 28-week prenatal visit, she reports increased clear vaginal discharge and feelings of pelvic pressure. Examination of her cervix reveals 2-cm dilation and a presenting fetal part low in the pelvis. TA is admitted to the hospital, and uterine activity is documented. Magnesium sulfate therapy is ordered for treatment of preterm labor. The nurse prepares for IV magnesium sulfate administration.

1. How will magnesium sulfate therapy be initiated? What intervals and dosages should be anticipated?

2. What maternal and fetal side effects will the nurse expect to observe?

3. What should TA be told about the drug effects she will experience?

4. How would the nurse respond to TA’s questions about the risks of preterm

   delivery?
   After 24 hours of magnesium sulfate therapy, uterine contractions have been

   reduced to two to three per hour. TA is to be discharged home, and the nurse is

   preparing TA’s discharge teaching.

5. What instructions should the nurse give TA about her activity and diet?

6. TA asks whether the side effects of magnesium sulfate will continue. What is an

   appropriate nursing response?

7. What signs and symptoms should TA be advised to report?

Answer 1

Answer: The magnesium sulfate therapy is initiated as it is given through IV only. The initial dose Or the infusion take place and given about 4 grams to 6 grams over the period of 15 minutes and 30 minutes. The dose should be maintained 2- 3 grams per hour. After the dose Or the therapy started, the women should be monitored for any kind of adverse or toxic effects. There could be chances of cardiac arrest Or respiratory depression, if the dose increases above the therapeutic level.