Pharmacology Reproductive & Maternity Meds #3

Question

A nurse is assessing a client who has preeclampsia with severe symptoms and is receiving IV magnesium sulfate. What should the nurse monitor in this patient related to the potential side effects? Select all that apply.

Answers

  1. Fundal firmness
    • Rationale:

      This answer is not correct because an expected side effect of magnesium sulfate is not fundal firmness. Oxytocin is given to help firm a boggy uterus. Magnesium sulfate has side effects which includes decreased respiratory rate, level of consciousness, and deep tendon reflexes.

  2. Fetal lung maturity
    • Rationale:

      This answer is not correct because magnesium sulfate is not administered to mature the fetus’ lungs nor is it a side effect of the medication. Betamethasone is a glucocorticoid steroid given in-utero to help speed-up the maturity of the lungs of a preterm baby. Intramuscular betamethasone is given in low doses, as soon as possible when preterm birth is inevitable.

  3. Tendon reflexes
    • Rationale:

      This answer is correct because magnesium sulfate has side effects which includes decreased respiratory rate, level of consciousness, and deep tendon reflexes. The nurse should monitor the patient for early toxicity symptoms so the patient will not experience extreme respiratory depression or respiratory or cardiac collapse. If symptoms begin to occur, the health care provider should be notified and the magnesium sulfate decreased or discontinued. Intravenous calcium gluconate is the antidote for magnesium sulfate toxicity.

  4. Vaginal bleeding
    • Rationale:

      This answer is not correct because magnesium sulfate does not have a side effect of vaginal bleeding. If the patient has vaginal bleeding, the healthcare provider should be notified immediately.

  5. Respiratory rate
    • Rationale:

      This answer is correct because magnesium sulfate has side effects which includes decreased respiratory rate, level of consciousness, and deep tendon reflexes. The nurse should monitor the patient for early toxicity symptoms so the patient will not experience extreme respiratory depression or respiratory or cardiac collapse. If symptoms begin to occur, the health care provider should be notified and the magnesium sulfate decreased or discontinued. Intravenous calcium gluconate is the antidote for magnesium sulfate toxicity.

Overview

Magnesium sulfate is given to help prevent seizures in a patient with preeclampsia. Toxicity can occur so the nurse should be careful to monitor and respond to any indications of potential toxicity.

Explanation

Learning Outcomes

Magnesium sulfate is the drug of choice in preeclampsia to help prevent seizures in the pregnant patient. Although effective, magnesium sulfate can become toxic. Toxicity symptoms include decreased respiratory rate, level of consciousness, and deep tendon reflexes. The nurse should monitor the patient for early toxicity symptoms so the patient will not experience extreme respiratory depression or respiratory or cardiac collapse. If symptoms begin to occur, the health care provider should be notified and the magnesium sulfate decreased or discontinued. Intravenous calcium gluconate is the antidote for magnesium sulfate toxicity.

Test Taking Tip

Be sure to focus studies on medications that have “toxicities”. NCLEX will want to know if you know those medications, the symptoms of toxicity, treatment, and what to do first.

Video Rationale