MEDizzy - A client is admitted at 30 weeks’ gestation with

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The Multigravid Client in Labor

A client is admitted at 30 weeks’ gestation with contractions every 3 minutes. Her cervix is 1 to 2 cm dilated and 75% effaced. Following a 4-g bolus dose, I.V. magnesium sulfate is infusing at 2 g/hour. How will the nurse know the medication is having the intended effect?

ExplanationThe expected outcome of magnesium sulfate administration is suppression of the contractions because the client is in preterm labor. Magnesium sulfate is a smooth muscle relaxant used to slow and stop contractions. Having contractions that lead to delivery is not the intended effect of this drug when used for preterm labor. Respirations lower than 12 breaths/minute may indicate magnesium sulfate toxicity. Another use of magnesium sulfate is to treat preeclampsia by preventing seizures and, secondarily, lowering maternal blood pressure. However, in this scenario, preterm labor—not preeclampsia—is being treated.