The nurse continues to care for the client who is at 30 weeks of gestation. The nurse is evaluating the client's response to interventions. Click to highlight the findings that indicate the client's condition has improved. To deselect a finding, click on the finding again. Vital Signs 1800: Temperature 38.3° C (101° F) Heart rate 58/min Respiratory rate 18/min Blood pressure 146/96 mm Hg Oxygen saturation 95% on 2 L nasal cannula Nurses' Notes 1800: DTR 2+ bilaterally Urine output 40 mL in the last hour

Rationale for correct choices • Deep tendon reflexes (DTR) 2+ bilaterally: At 1400, the client’s DTRs were severely diminished at 1+, a hallmark sign of magnesium toxicity. The return of DTRs to 2+ demonstrates recovery of neuromuscular function, indicating that magnesium levels are moving back into the safe therapeutic range and the risk of severe complications like paralysis is decreasing. • Urine output 40 mL in the last hour: Adequate urine output shows the kidneys are effectively excreting magnesium. Magnesium toxicity is more likely when renal function is impaired. Improvement in urine output indicates the body is eliminating excess magnesium, supporting recovery and reducing ongoing toxicity risk. • Respiratory rate 18/min with oxygen saturation 95% on 2 L nasal cannula: Previously, the client had a severely depressed respiratory rate of 8/min and oxygen saturation of 91%, indicating significant magnesium-induced respiratory depression. The increase to 18 breaths/min with improved oxygenation reflects restoration of respiratory function, which is an indicator of improvement from magnesium toxicity. Rationale for findings not indicating improvement • Temperature 38.3° C (101° F): Fever does not reflect magnesium toxicity or its resolution. This is a new finding of fever, which may indicate the development of an infection (such as chorioamnionitis or a UTI from the catheter) or a reaction to medications. • Blood pressure 146/96 mm Hg: While slightly lower than the peak of 156/96, the diastolic pressure (96) remains high, indicating the underlying preeclampsia is still active and unresolved.