# A client with severe preeclampsia receives magnesium sulfate. Highlight the findings that require immediate medication follow-up.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=522094&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client with severe preeclampsia receives magnesium sulfate. Highlight the findings that require immediate medication follow-up.

| Domain | Finding |
| --- | --- |
| Respiratory | Respirations decreased to 8/min |
| Neurologic | Patellar reflexes are absent |
| Renal | Urine output is 20 mL during the past hour |
| Neurologic | The client is increasingly difficult to arouse |
| Fetal | Baseline fetal heart rate is 140/min with moderate variability |
| Circulation | Blood pressure decreased from 170/108 to 148/94 mm Hg |
| Therapy | The infusion is connected to a pump |
| Access | The IV site has no redness or swelling |

## Explanation

Bradypnea, absent deep-tendon reflexes, falling urine output, and increasing somnolence indicate magnesium accumulation and require stopping the infusion and urgent evaluation and rescue readiness.

## In-depth explanation

Quick answer
Escalate respiratory, reflex, renal, and consciousness deterioration.

Why this is correct
Magnesium is cleared by the kidneys and excessive levels depress neuromuscular and respiratory function. Maternal assessment must drive immediate action.

Easy analogy or mental picture
Treat medication safety like airway triage: identify the threat, interrupt exposure, support physiology, and verify a durable response.

Memory hook
Cue, risk, action, response, recurrence check.

NCLEX decision rule
Choose the action that prevents the most immediate medication-related harm while preserving reassessment and escalation.

Why the other choices are wrong
Options that normalize deterioration, add interacting medication, or delay rescue leave the safety loop open.References
1DailyMed: Magnesium Sulfate in Water for InjectionNeuromuscular and respiratory depression, renal clearance, monitoring, and maternal-newborn toxicity

## Clinical scenario

Medication safety review
Verify the indication, current assessment, respiratory and neurologic status, interactions, authorized rescue action, and measurable follow-up.

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