The nurse is caring for a client with severe preeclampsia receiving a continuous infusion of magnesium sulfate. Which of the following manifestations would indicate the client is experiencing an adverse effect of this medication?
The nurse is caring for a client with severe preeclampsia receiving a continuous infusion of magnesium sulfate. Which of the following manifestations would indicate the client is experiencing an adverse effect of this medication?
A. Blurred vision
[19%]
B. Tachypnea
[7%]
C. Pain in the epigastric region
[3%]
D. Respiratory depression
[71%]
Statistics
Subject/Lesson
Subject
Maternal & Newborn Health
Lesson
Labor/Delivery
Client Need
Test Plan
Pharmacological and Parenteral Therapies
Related Topic
Adverse Effects/Contraindications/Side Effects/Interactions
Item Type
Item Type
Analysis
Explanation
Choice D is correct. When administering magnesium sulfate, the nurse should monitor the client for respiratory depression. Magnesium toxicity can lead to respiratory paralysis, central nervous system depression, and cardiac arrest. If respiratory depression or another sign of magnesium toxicity is noted, the antidote is calcium gluconate, one gram, infused intravenously over two minutes.
Choice A is incorrect. When evaluating clients with preeclampsia, certain accompanying features are considered severe, including visual disturbances. Although visual disturbances, including blurring of vision, should be immediately reported to the client's health care provider (HCP), the client's blurred vision does not result from the magnesium sulfate administration.
Choice B is incorrect. Following the administration of magnesium sulfate, the nurse would not be monitoring the client for tachypnea. After administering the medication, the nurse would correctly monitor the client for forms of respiratory depression (e.g., bradypnea, respiratory arrest, etc.) potentially occurring as an unintended result of magnesium toxicity.
Choice C is incorrect. When evaluating clients with preeclampsia, certain accompanying features are considered severe, including epigastric or right upper quadrant abdominal pain. Although the nurse should further assess the client's epigastric pain complaint, this complaint is not related to the magnesium sulfate administration.
Learning Objective
Recognize the need for the nurse to monitor the client for respiratory depression while receiving magnesium sulfate.
Related Videos
2 Key Topics
Tocolytics & Oxytotics
30.2 Preterm Labor & Medications
Additional Info
✓ Magnesium sulfate is the treatment of choice for clients with preeclampsia to prevent eclamptic seizures and placental abruption.
✓ Calcium gluconate should be kept at the bedside in case of respiratory depression from magnesium sulfate use.
✓ Magnesium sulfate slows neuromuscular conduction and depresses central nervous system irritability without significant effects on blood pressure. Maternal vital signs, deep tendon reflexes, and urinary output need to be closely monitored.
✓ Treat eclampsia immediately with magnesium sulfate to prevent seizures from recurring; consider magnesium sulfate for seizure prophylaxis in clients who have preeclampsia with severe features, but usually not in those with mild preeclampsia.
