A woman is being administered IV magnesium sulfate. What is a desired outcome related to the administration of magnesium sulfate?

Correct Answer: C

Rationale: Magnesium sulfate is commonly used in obstetrics to prevent seizures in women with preeclampsia or eclampsia, as well as to stop preterm labor. The desired outcome related to the administration of magnesium sulfate is to decrease blood pressure (Choice C). Magnesium sulfate has vasodilatory effects which help to lower blood pressure in women with preeclampsia or eclampsia, reducing the risk of complications such as stroke or organ damage. Choice A (Increased contractions) is incorrect because magnesium sulfate is actually used to stop preterm labor by relaxing the uterine muscles and preventing contractions. It is a tocolytic agent, not a uterotonic. Choice B (Respiratory rate above 18) is incorrect because magnesium sulfate can actually depress the respiratory system, leading to respiratory depression or even respiratory arrest in high doses. Therefore, it is important to monitor the respiratory rate closely when administering magnesium sulfate. Choice D (Increased uterine tone) is incorrect because, as mentioned earlier, magnesium sulfate is a tocolytic agent that relaxes the uterine muscles to prevent preterm labor. It does not increase uterine tone. In fact, it is used to delay delivery to allow for the administration of corticosteroids to improve fetal lung maturity.

Correct Answer: D

Rationale: Terbutaline sulfate (Brethine) is a beta-adrenergic agent that inhibits uterine contractions by reducing intracellular calcium levels. Adverse effects may include hyperkalemia, hyperglycemia, cardiac dysrhythmias, hypotension, and pulmonary edema. Women commonly experience hand tremors, palpitations, and shortness of breath with chest tightness.

Correct Answer: A

Rationale: A bulk-producing agent, such as Metamucil, is most physiologic for the mother and safe for the fetus. Mineral oil is not recommended because of the lack of absorption of fat-soluble vitamins. Saline cathartics are not recommended because of hypernatremia. Stimulant cathartics are not recommended for the pregnant woman.

Correct Answer: C

Rationale: Choice A is incorrect because discontinuing HAART during pregnancy can actually increase the risk of HIV transmission from mother to child. HAART is crucial in reducing the viral load in pregnant women with HIV, therefore discontinuation would be detrimental. Choice B is incorrect because increasing the dosage of HAART during pregnancy is not a standard practice. The goal is to maintain the viral load at a low level to reduce the risk of transmission to the baby, but this can usually be achieved with the standard regimen without the need for dosage adjustments. Choice D is incorrect because not all components of HAART are contraindicated during pregnancy. While some drugs may need to be switched due to potential teratogenic effects, many of the medications used in HAART are safe to use during pregnancy and can be continued without any changes. The correct answer, choice C, is supported by guidelines from organizations such as the World Health Organization and the Centers for Disease Control and Prevention, which recommend that pregnant women with HIV continue their HAART regimen unchanged if it is effective and well-tolerated. This helps to control the viral load, reduce the risk of transmission to the baby, and maintain the health of the mother.

Correct Answer: B

Rationale: Hypertension (choice B) is the correct answer as a maternal adverse effect of Pitocin. Pitocin, a synthetic form of oxytocin, is commonly used to induce labor or augment contractions. It can lead to hypertension in some patients due to its vasoconstrictive effects. This can result in increased blood pressure, which can be harmful to both the mother and the baby. Acute confusion (choice A) is not typically associated with Pitocin administration. Confusion may be a sign of other underlying conditions or complications, but it is not a direct adverse effect of Pitocin. Edema (choice C) is also not a common adverse effect of Pitocin. Edema refers to swelling caused by excess fluid trapped in the body's tissues, and it is not typically caused by Pitocin administration. Inverted T wave (choice D) on an electrocardiogram (ECG) is not a known adverse effect of Pitocin. Inverted T waves can be indicative of cardiac issues such as ischemia or electrolyte imbalances, but they are not directly linked to Pitocin administration. Overall, hypertension is the correct maternal adverse effect of Pitocin due to its vasoconstrictive properties, while acute confusion, edema, and inverted T waves are not typically associated with Pitocin administration.