A charge nurse is educating a newly licensed nurse about fluid and electrolyte balance. Which of the following manifestations should the newly licensed nurse identify as a sign of magnesium sulfate toxicity?

A. Providing clients with information about the benefits of exercise: This is an example of primary prevention, aimed at promoting general health and preventing illness before it occurs, not managing an existing condition like HIV.
B. Using an electronic messaging system to remind clients when to take medications: This represents tertiary prevention, which focuses on managing chronic illness to prevent complications and improve quality of life. Medication adherence helps control HIV progression and maintain health.
C. Helping clients understand health screenings covered by their insurance plans: This is a secondary prevention activity, aimed at early detection of disease through screening, rather than managing an existing diagnosis.
D. Educating clients about contraindications to specific immunizations: This aligns with primary prevention, as it relates to preventing illness through safe vaccination practices, not managing or treating an existing chronic disease.

A. Stop the procedure: Stopping the blood transfusion immediately is the priority to prevent further exposure to the potentially harmful blood product causing the wheezing. This action helps minimize the risk of progression to a more severe transfusion reaction or anaphylaxis.
B. Administer an antihistamine: Antihistamines may relieve allergic symptoms but should only be given after the transfusion is stopped and the client is assessed. Administering medication without stopping the transfusion first could worsen the reaction.
C. Administer oxygen: Providing oxygen supports the client’s respiratory function during wheezing, which may indicate hypoxia. Oxygen administration is important but secondary to stopping the transfusion to eliminate the cause.
D. Initiate an infusion of 0.9% sodium chloride using new tubing: Starting a saline infusion with new tubing helps maintain IV access and prevent clotting after stopping the transfusion. This action is necessary but follows stopping the transfusion as the first priority.