# Place the steps for starting a prescribed magnesium sulfate maintenance infusion for severe preeclampsia in order. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=514128&lang=en > language: en > subject: Adverse Effects/Contraindications/Interactions > category: PPT ## Question Place the steps for starting a prescribed magnesium sulfate maintenance infusion for severe preeclampsia in order. Continue serial respiratory, reflex, urine-output, magnesium, and fetal-maternal assessment during the infusion. Confirm patellar reflexes, respiratory rate, urine output, renal function, and the authorized maintenance dose. Program 50 mL/hr to deliver 2 g/hr from a 20 g in 500 mL bag. Verify the concentration: 20 g in 500 mL equals 40 mg/mL. Stop the infusion and activate the toxicity response if respirations or reflexes become depressed. ## Explanation Assessment comes first, followed by concentration verification, rate calculation and programming, active monitoring, and toxicity response when indicated. ## In-depth explanation Quick answer Use assess - verify concentration - calculate and program - monitor - stop for toxicity. Why this is correct 20 g in 500 mL is 0.04 g/mL or 40 mg/mL. A 2-g hourly dose therefore requires 50 mL/hr. Renal impairment increases magnesium accumulation risk, so reflexes, respirations, output, and levels are essential. Easy analogy or mental picture Check the client before the bag, solve the bag before the pump, then keep watching the client. Memory hook Client, concentration, rate, trend, rescue. NCLEX decision rule Calculation is not complete until the pre-infusion safety assessment and post-programming monitoring are linked to it. Why the other choices are wrong Programming before assessment can deliver magnesium into impaired clearance, while delayed response to depressed breathing or reflexes permits toxicity to progress.References 1DailyMed: Magnesium Sulfate in Water for InjectionOne-to-two-gram hourly maintenance, reflex and respiratory monitoring, and renal maximum ## Clinical scenario Magnesium infusion sequence Verify renal clearance, urine output, reflexes, respirations, bag concentration, g/hr order, mL/hr setting, and toxicity response supplies. ## Related questions - [A client is admitted to the emergency department after ingesting an unknown amount of acet…](https://mymerci.kr/pages/nclex_q.php?qn_id=362720&lang=en) - [A client with chronic heart failure is prescribed metoprolol 25 mg orally twice daily. Bef…](https://mymerci.kr/pages/nclex_q.php?qn_id=362756&lang=en) - [A 28-year-old client with type 1 diabetes receives regular insulin 6 units and NPH insulin…](https://mymerci.kr/pages/nclex_q.php?qn_id=362792&lang=en) - [A client receives IV vancomycin 1 g every 12 hours for MRSA bacteremia. Before the next do…](https://mymerci.kr/pages/nclex_q.php?qn_id=362833&lang=en) - [A client with bipolar disorder has been taking lithium carbonate 600 mg orally three times…](https://mymerci.kr/pages/nclex_q.php?qn_id=362894&lang=en) - [A nurse is monitoring a client receiving a continuous IV heparin infusion for pulmonary em…](https://mymerci.kr/pages/nclex_q.php?qn_id=363988&lang=en) - [A nurse is preparing to initiate a weight-based continuous IV unfractionated heparin infus…](https://mymerci.kr/pages/nclex_q.php?qn_id=364107&lang=en) - [A nurse is providing discharge teaching to a 65-year-old client newly prescribed warfarin …](https://mymerci.kr/pages/nclex_q.php?qn_id=364872&lang=en) ## Read in another language - [en](https://mymerci.kr/pages/nclex_q.php?qn_id=514128&lang=en) - [ko](https://mymerci.kr/pages/nclex_q.php?qn_id=514128&lang=ko) - [ja](https://mymerci.kr/pages/nclex_q.php?qn_id=514128&lang=ja) - [zh-TW](https://mymerci.kr/pages/nclex_q.php?qn_id=514128&lang=zh-tw) - [vi](https://mymerci.kr/pages/nclex_q.php?qn_id=514128&lang=vi) --- More free questions: [NCLEX-RN Practice](https://mymerci.kr/pages/nclex_bank.php?lang=en) _For study reference only. Always follow current clinical guidelines and your institution’s protocols._