A client with severe PIH receiving MgSO4 is placed in a quiet, darkened room.
The nurse bases this action on the following understanding:
A . The client is restless.
B . The elevated blood pressure causes photophobia.
C . Noise or bright lights may precipitate a convulsion.
D . External stimuli are annoying to the client with PI
Answer: C
Explanation:
(A) The client may be anxious and hyperresponsive to stimuli but not necessarily restless.
(B) This is not a physiological response to an elevated blood pressure in PIH.
(C) The nurse must know the nursing measures that decrease the potential for convulsions. A quiet, darkened room decreases stimuli and promotes rest.
(D) External stimuli might induce a convulsion but are not annoying to the client with PIH.