A nurse is assisting with monitoring a client who has preeclampsia and is receiving magnesium sulfate.
The client’s respiratory rate is 8 breaths/min and the nurse suspects toxic levels of magnesium.
Which of the following should the nurse administer?
A Calcium gluconate.
B Flumazenil.
C Naloxone.
D Protamine sulfate.
the correct answer and explanation is:
The correct answer is A) Calcium gluconate.
Explanation:
Magnesium sulfate is often administered to pregnant clients with preeclampsia to prevent seizures and manage blood pressure. However, one of the significant risks associated with magnesium sulfate therapy is toxicity, which can manifest in various ways, including respiratory depression. In this scenario, the client has a respiratory rate of 8 breaths per minute, which is indicative of possible magnesium toxicity.
Magnesium toxicity can lead to respiratory depression, reduced deep tendon reflexes, and even cardiac arrest. It is crucial for the nurse to recognize these signs and act promptly to counteract the effects of excessive magnesium.
Calcium gluconate is the antidote for magnesium sulfate toxicity. It acts as a calcium antagonist and competes with magnesium at the neuromuscular junction, thereby reversing the effects of magnesium toxicity. Administering calcium gluconate helps to restore normal neuromuscular function and alleviates symptoms such as respiratory depression.
Here’s a brief overview of why the other options are not suitable:
- B) Flumazenil is a benzodiazepine antagonist used to reverse benzodiazepine overdoses, not magnesium toxicity.
- C) Naloxone is an opioid antagonist used for opioid overdoses. It is not effective for magnesium toxicity.
- D) Protamine sulfate is used to reverse the effects of heparin (an anticoagulant) and is not related to magnesium sulfate toxicity.
In summary, when managing magnesium sulfate toxicity, particularly when respiratory depression is noted, the appropriate treatment is calcium gluconate. It should be administered quickly to mitigate the effects of excess magnesium and protect the client’s respiratory function and overall well-being.