The Patient Is Admitted to the Hospital, and an Intravenous

question 445

Multiple Choice

The patient is admitted to the hospital, and an intravenous line and urinary catheter are placed.  She receives corticosteroids to accelerate fetal lung maturity and magnesium sulfate for fetal neuroprotection.  Three hours later, the patient develops dyspnea and has a drop in arterial oxygen saturation.  Temperature is 36.7 C (98.1 F) , blood pressure is 150/80 mm Hg, pulse is 112/min, and respirations are 24/min.  Pulse oximetry is 91% on room air.  Examination shows bibasilar crackles and use of accessory muscles for breathing.  Heart sounds are tachycardic and without murmur.  There is 3+ pitting edema of the lower extremities, and deep tendon reflexes are 2+ bilaterally.  The remainder of the examination is normal.  Urine output is 60 mL/hr.  What is the most likely cause of this patient's respiratory symptoms?

• A)Amniotic fluid embolism
• B)Bronchospasm
• C)Magnesium sulfate toxicity
• D)Peripartum cardiomyopathy
• E)Pulmonary edema
• F)Pulmonary embolus

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