A nurse is administering magnesium sulfate IV to a client who has severe preeclampsia.

Which of the following assessments should the nurse perform to monitor for magnesium toxicity? Select all that apply.

Calcium gluconate is the antidote for magnesium sulfate toxicity because it reverses the effects of magnesium on the neuromuscular and cardiovascular systems.

Magnesium sulfate can cause respiratory depression, hypotension, bradycardia, and cardiac arrest in high doses.

Choice B. Naloxone is wrong because it is the antidote for opioid overdose, not magnesium sulfate toxicity.

Naloxone blocks the opioid receptors and restores breathing and consciousness.

Choice C. Flumazenil is wrong because it is the antidote for benzodiazepine overdose, not magnesium sulfate toxicity.

Flumazenil binds to the benzodiazepine receptors and reverses the sedative and hypnotic effects.

Choice D. Protamine sulfate is wrong because it is the antidote for heparin overdose, not magnesium sulfate toxicity.

Protamine sulfate neutralizes the anticoagulant effect of heparin and prevents bleeding.

Normal ranges for magnesium are 1.5 to 2.5 mEq/L or 0.75 to 1.25 mmol/L.

The correct answer is choice A and E. The nurse should check the client’s blood pressure and magnesium level before giving hydralazine to a client with severe pre-eclampsia who is receiving magnesium sulfate intravenously.

• Choice A is correct because hydralazine is an antihypertensive drug that lowers blood pressure by relaxing blood vessels.The nurse should monitor the client’s blood pressure before and after giving hydralazine to ensure that it is within the target range and to avoid hypotension or rebound hypertension.

• Choice B is wrong because pulse oximetry is not directly related to hydralazine administration or pre-eclampsia.Pulse oximetry measures the oxygen saturation of hemoglobin in the blood and can be affected by factors such as anemia, hypothermia, nail polish, or movement.

The nurse should monitor the client’s pulse oximetry as part of routine care, but it is not a priority before giving hydralazine.

• Choice C is wrong because checking the client’s reflexes is not directly related to hydralazine administration or pre-eclampsia.Reflexes are assessed to monitor for signs of magnesium toxicity, which can cause muscle weakness, respiratory depression, and cardiac arrest.

The nurse should check the client’s reflexes as part of routine care, but it is not a priority before giving hydralazine.

• Choice D is wrong because checking the client’s urine specific gravity is not directly related to hydralazine administration or pre-eclampsia.Urine specific gravity measures the concentration of solutes in the urine and can be affected by factors such as hydration status, renal function, or diuretic use.

The nurse should monitor the client’s urine specific gravity as part of routine care, but it is not a priority before giving hydralazine.

• Choice E is correct because magnesium sulfate is a drug that prevents and treats seizures in women with severe pre-eclampsia or eclampsia.The nurse should monitor the client’s magnesium level before and after giving magnesium sulfate to ensure that it is within the therapeutic range and to avoid magnesium toxicity.