Identify eight measures that would likely be implemented
What will be an ideal response?
• Initiate IV therapy, anticipating that oxytocin (Pitocin) might be ordered for induction.
• Have misoprostol available if ordered to soften the cervix.
• Have IV magnesium sulfate available to be given intravenously if ordered.
• Check for signs and symptoms of magnesium sulfate toxicity, if ordered.
• Keep an emergency box by the bedside for possible seizures and magnesium sulfate toxicity.
• Have oxygen administration equipment ready to use.
• Check VS hourly. If induced, monitor contractions every 15 minutes.
• Keep her NPO except for ice chips.
• Strictly monitor intake and output.
• Evaluate fetal status with continuous monitoring of fetal heart rate (FHR).
• Evaluate visual disturbance and headaches, indicating cerebral edema.
• Evaluate epigastric pain, indicating swelling of the liver.
• Evaluate edema, DTRs, clonus every 4 hours.
• Provide one-on-one care.
• Educate J.F. about the severity of her disease and that the only cure is delivery.
• Keep the environment as quiet as possible, nonstimulating, with lighting subdued.
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