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RN Nursing · Adverse Effects, Interactions, and Contraindications · Practice question

A nurse is caring for a client who is at 30 weeks of gestation and has a prescription for magnesium sulfate IV to treat preterm labor. The nurse should notify the provider of which of the following adverse effects?

Answer & explanation

Correct: Respiratory rate 10/min

Magnesium sulfate is a CNS depressant and a high-alert medication. Signs of magnesium toxicity include respiratory rate less than 12/min, absent deep tendon reflexes, urinary output less than 30 mL/hr, and decreasing level of consciousness. A respiratory rate of 10/min indicates toxicity and requires the nurse to stop the infusion, notify the provider, and prepare calcium gluconate, the antidote. Nausea and flushing/warmth are common, expected side effects of magnesium sulfate infusion. A urinary output of 40 mL/hr is adequate (greater than 30 mL/hr) and does not indicate toxicity—reduced output would risk magnesium accumulation (ATI Maternal Newborn Nursing).

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