[Expert Solution]: M.R

M.R. is a 15-year-old G2P0 at 37 weeks’ gestation who presents to labor and delivery with the complaint of regular contractions for the past 2 hours. She denies bleeding or loss of fluid from the vagina. She reports active fetal movement. On evaluation, the nurse notes that M.R.’s B/P is 148/92 and she has 2+ proteinuria. Her reflexes are 3+ bilaterally, with no clonus. EFM is reactive and within normal limits. QUESTIONS: 1. Based on the above scenario, what is your assessment of M.R.? Gestational Age and Labor: M.R. is at term (37 weeks) and experiencing regular contractions, suggesting the onset of labor. Preeclampsia Indicators: The elevated blood pressure, proteinuria, and hyperreflexia are indicative of preeclampsia, a condition that requires careful monitoring and management to prevent complications for both the mother and the fetus. Fetal Well-being: The electronic fetal monitoring (EFM) is reactive and within normal limits, indicating that the fetus is currently not in distress. In conclusion, M.R. is likely in early labor with signs of preeclampsia, necessitating close monitoring and potential intervention to ensure the safety of both mother and child. Top of Form 2. List 3 other symptoms and the underlying pathophysiology of these symptoms that the nurse should assess for in obtaining M.R’s history? The physician performs a vaginal exam and determines that M.R. is 2 cm/80%/0 station with intact membranes. Orders are written for admission to L&D and initiation of Magnesium Sulfate therapy? 3. Why is Magnesium Sulfate given in this scenario? Discuss the mechanism of action of Magnesium Sulfate. What is the typical loading dose and maintenance dose? 4. Understanding the pharmacodynamics of magnesium sulfate, what might the nurse expect to see in M.R.’s contraction pattern? What medication might be needed to correct this? Three hours after starting Magnesium sulfate, you notice that it is difficult to arouse M.R. and her urine output is 20 cc/hour, her reflexes are 0 and her respiratory rate is 10 breaths/minute. 5. What is your assessment of the above findings? What is the most important nursing action to take?