A client who is receiving magnesium sulfate has a urine output of 20 mL/hr. Which of the following medications should the nurse expect to administer?

Choice A reason: Bradycardia is not an indication of circulatory overload. Bradycardia is a slow heart rate, usually below 60 beats per minute. Circulatory overload causes the heart to work harder to pump the excess fluid in the blood vessels, which can result in tachycardia, or a fast heart rate, usually above 100 beats per minute.

Choice B reason: Flushing is not an indication of circulatory overload. Flushing is a reddening of the skin, usually due to increased blood flow or inflammation. Circulatory overload causes the blood vessels to constrict and increase the blood pressure, which can result in pallor, or a pale appearance of the skin.

Choice C reason: Vomiting is not an indication of circulatory overload. Vomiting is the forceful expulsion of stomach contents through the mouth, usually due to nausea, infection, or irritation. Circulatory overload does not affect the gastrointestinal system directly, although it may cause abdominal distension or ascites, which is the accumulation of fluid in the abdominal cavity.

Choice D reason: Dyspnea is an indication of circulatory overload. Dyspnea is the sensation of difficulty breathing, usually due to inadequate oxygen delivery to the tissues. Circulatory overload causes the excess fluid in the blood vessels to leak into the lungs, which can result in pulmonary edema, or the accumulation of fluid in the alveoli. This impairs the gas exchange and causes hypoxia, or low oxygen levels in the blood.

Choice A reason: This is incorrect because dextrose 5% in 0.45% sodium chloride is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.

Choice B reason: This is correct because 0.9% sodium chloride is a isotonic solution that is compatible with blood products. It does not cause hemolysis or fluid shifts and maintains the osmotic pressure of the blood.

Choice C reason: This is incorrect because lactated Ringer's solution is a isotonic solution that contains electrolytes, such as potassium, calcium, and lactate, that can interfere with the blood products. It can also cause metabolic alkalosis due to the conversion of lactate to bicarbonate.

Choice D reason: This is incorrect because dextrose 5% in water is a hypotonic solution that can cause hemolysis of the RBCs. It can also cause fluid shifts from the intravascular to the intracellular space, leading to edema and hypotension.