A nurse is preparing to administer intravenous magnesium sulfate to a client who has preeclampsia. The nurse should monitor the client for which of the following adverse effects of magnesium toxicity?

Choice A reason:

A positive Chvostek's sign is a facial twitch that occurs when the facial nerve is tapped. This is a sign of hypocalcemia, which causes increased neuromuscular excitability. According to index 2, a nurse can assess for Chvostek's sign by tapping the cheek just below the temple. If the facial muscles contract, the sign is positive.

Choice B reason:

Decreased deep tendon reflexes are not a sign of hypocalcemia, but rather of hypercalcemia, which causes decreased neuromuscular excitability. According to index 5, symptoms of hypercalcemia include muscle weakness, fatigue, constipation, nausea, vomiting, and confusion.

Choice C reason:

Muscle weakness is also not a sign of hypocalcemia, but rather of hyperkalemia, which causes impaired muscle contraction. According to index 1, a nurse can assess for muscle weakness by testing the client's grip strength and ability to lift the legs against resistance. If the client has difficulty performing these tasks, they may have hyperkalemia.

Choice D reason:

Hypoactive bowel sounds are not a sign of hypocalcemia, but rather of ileus, which is a paralysis of the intestinal muscles that causes obstruction. Ileus can be caused by various factors, such as surgery, infection, medication, or electrolyte imbalance. According to index 6, symptoms of ileus include abdominal pain, distension, nausea, vomiting, and constipation.

Choice A reason:

Tachycardia is not a sign of magnesium toxicity. Magnesium sulfate can cause bradycardia or slow heart rate as a side effect.

Choice B reason:

Diarrhea is not a sign of magnesium toxicity. Magnesium sulfate can cause constipation or decreased bowel movements as a side effect.

Choice C reason:

Respiratory depression is a sign of magnesium toxicity. Magnesium sulfate can cause decreased respiratory rate or difficulty breathing as a side effect. This is a serious complication that requires immediate intervention by the nurse, such as discontinuing the infusion and administering calcium gluconate as an antidote.

Choice D reason:

Hyperthermia is not a sign of magnesium toxicity. Magnesium sulfate can cause hypothermia or low body temperature as a side effect.