A nurse is caring for a client who is receiving magnesium sulfate IV bolus for preeclampsia. The client's respiratory rate is 6/min and they have absent deep tendon reflexes. Which of the following medications should the nurse anticipate the provider to prescribe?

Rationale for Correct Choices:

• Heart rate: The client’s heart rate has increased from 58/min to 118/min, indicating possible thyrotoxicosis or over-replacement of levothyroxine. Tachycardia is a priority finding because it can lead to cardiovascular complications such as arrhythmias or chest pain.
• Pain: The client reports chest pain, which, combined with tachycardia and elevated blood pressure, may indicate cardiac strain or complications. Prompt assessment of pain helps identify potential cardiovascular compromise requiring urgent intervention.

Rationale for Incorrect Choices

• Weight: While notable changes in weight are important for monitoring thyroid treatment, they are not immediately life-threatening compared with tachycardia and chest pain.
• Skin: Skin changes provide supportive assessment information but are less immediately critical than cardiovascular status.
• Temperature: Elevated temperature indicates hypermetabolism or possible infection, but it is not as immediately life-threatening as the tachycardia and chest pain.
• Bowel sounds: Hyperactive bowel sounds reflect increased GI motility but are less urgent compared with cardiovascular and metabolic indicators.

A. "I have vomited several times.": Vomiting can be a side effect of penicillin, but it is usually manageable and not immediately life-threatening unless severe dehydration occurs.

B. "I am having diarrhea.": Mild diarrhea is a common side effect of antibiotics. It is important to monitor for signs of C. difficile infection, but occasional loose stools are not immediately critical.

C. "I am having trouble swallowing.": Difficulty swallowing may indicate oropharyngeal edema, which can be a sign of a severe allergic reaction to penicillin. This requires immediate attention as it can progress to airway obstruction.

D. "My skin feels itchy all over.": Generalized itching may indicate a mild allergic reaction. While it should be monitored, it is less urgent than symptoms suggesting airway compromise.