Magnesium Sulfate on the NCLEX
Mag sulfate in OB: pre-eclampsia/eclampsia seizure prophylaxis. Toxicity, antidote calcium gluconate.
Magnesium sulfate is high-alert in obstetrics. Used for pre-eclampsia, eclampsia, and tocolysis. NCLEX hammers toxicity monitoring.
Use
Pre-eclampsia/eclampsia seizure prophylaxis. Tocolysis (preterm labor).
Therapeutic level
4-7 mEq/L for seizure prophylaxis.
Toxicity signs (progressive)
Decreased DTRs (first sign, loss of patellar reflex). Respiratory depression (RR <12). Hypotension. Decreased urine output (<30 mL/h). Cardiac arrest at very high levels.
Antidote
Calcium gluconate IV. Should be at bedside.
Monitoring
DTRs hourly. RR. UO (>30 mL/h required). Mag level.
Frequently asked
Loss of patellar reflex, what to do?
Hold infusion immediately. Notify provider. Check mag level. Calcium gluconate ready.
Continue mag post-partum?
Yes, seizure risk persists 24-48h post-delivery.
Quick check
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