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A nurse is caring for a client who is receiving magnesium sulfate IV bolus for preeclampsia. The client's respiratory rate is 6/min and they have absent deep tendon reflexes. Which of the following medications should the nurse anticipate the provider to prescribe?

A.

Dexamethasone

B.

Methylergonovine

C.

Naloxone

D.

Calcium gluconate

Answer and Explanation

The Correct Answer is D

A. Dexamethasone: Dexamethasone is a corticosteroid used to promote fetal lung maturity in preterm labor or to reduce inflammation. It does not counteract magnesium sulfate toxicity and is not indicated for respiratory depression or absent reflexes.

B. Methylergonovine: Methylergonovine is a uterotonic used to treat postpartum hemorrhage by stimulating uterine contractions. It does not reverse magnesium sulfate toxicity or address respiratory depression.

C. Naloxone: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression. Since the client’s symptoms are due to magnesium sulfate toxicity, naloxone would not be effective.

D. Calcium gluconate: Calcium gluconate is the antidote for magnesium sulfate toxicity. It works by antagonizing the effects of magnesium on neuromuscular and cardiac function, helping to restore normal reflexes and improve respiratory function.


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Related Questions

Correct Answer is B

Explanation

A. Nitroglycerin: Nitroglycerin is a vasodilator used to treat angina and does not have known interactions with vancomycin. Concurrent use does not increase the risk of vancomycin toxicity or adverse effects.

B. Furosemide: Furosemide is a loop diuretic that can be nephrotoxic and ototoxic, similar to vancomycin. Using both medications concurrently increases the risk of kidney damage and hearing loss, requiring careful monitoring of renal function and auditory status.

C. Calcium chloride: Calcium chloride is used for hypocalcemia and cardiac stabilization but does not interact directly with vancomycin. No enhanced toxicity or adverse reaction is expected when these drugs are administered together.

D. Morphine: Morphine is an opioid analgesic with no direct interaction with vancomycin. While both drugs may depress the central nervous system in different ways, morphine does not increase the risk of vancomycin-related nephrotoxicity or ototoxicity.

Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Explanation

Rationale for Correct Choices:

  • Diltiazem: Diltiazem is a calcium channel blocker commonly used to control ventricular rate in atrial fibrillation. The client’s ECG confirms atrial fibrillation with rapid ventricular response, making rate control a priority to prevent hemodynamic instability.
  • Cardiac rhythm: The rapid, irregular heart rate documented on ECG is the primary finding necessitating medication intervention to prevent further complications such as decreased cardiac output or thromboembolism.

Rationale for Incorrect Choices:

  • Dopamine: Dopamine is a vasopressor used to support blood pressure in hypotension or shock. While the client’s BP is mildly decreased, the immediate concern is rapid atrial fibrillation rather than hypotensive crisis.
  • Furosemide: Furosemide treats fluid overload and edema but does not directly address the acute arrhythmia causing tachycardia and hemodynamic compromise.
  • Albuterol nebulizer: Albuterol is used for bronchospasm and respiratory distress related to airway constriction. The client has clear lung sounds, so this is not indicated.
  • Alprazolam: Alprazolam can reduce anxiety but does not manage the underlying atrial fibrillation or prevent cardiovascular complications.
  • Edema, blood pressure, anxiety, dyspnea: While these are relevant assessments, they are secondary to the urgent need to control the cardiac rhythm in acute atrial fibrillation.

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