A client on PPI for 1 year has Mg 1.2 mEq/L and is ordered magnesium sulfate 2 g IV. Which is the priority assessment?

• 1 Liver function studies including ALT, AST, and bilirubin to assess for drug-induced hepatic injury from long-term PPI use
• 2 Deep tendon reflexes, respiratory rate, BP, urine output, and ECG — too-rapid infusion causes hypotension and DTR loss ✓ Correct answer
• 3 Visual acuity and extraocular movements to detect nystagmus or diplopia from rising magnesium levels
• 4 Capillary blood glucose every 4 hours because magnesium potentiates insulin action, risking hypoglycemia

For study reference only. Always follow current clinical guidelines and your institution’s protocols.