A nurse is monitoring a client receiving an infusion of IV magnesium sulfate. Which of the following findings would indicate to the nurse that the client is experiencing hypermagnesemia?

Hypertension and headache

Tachycardia and tachypnea

Depressed deep tendon reflexes

Positive Trousseau's sign

Answer and Explanation

The Correct Answer is C

A. Hypertension and headache are not typical signs of hypermagnesemia. These symptoms are more commonly associated with conditions like hypertension or intracranial pressure.
B. Tachycardia and tachypnea are not characteristic of hypermagnesemia. In fact, hypermagnesemia typically causes bradycardia and hypoventilation due to the depressant effect of magnesium on the cardiovascular and respiratory systems.
C. Depressed deep tendon reflexes are a classic sign of hypermagnesemia. Magnesium sulfate acts as a central nervous system depressant, and elevated magnesium levels can impair neuromuscular function, leading to reduced reflexes.
D. Positive Trousseau's sign is indicative of hypocalcemia, not hypermagnesemia. It is a sign of low calcium levels, where a blood pressure cuff inflated above systolic pressure for 3 minutes causes muscle spasms in the hand and forearm.

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Correct Answer is D

Explanation

A. A CT scan of the head is not indicated based on the laboratory findings provided. The priority intervention is related to the elevated potassium level.
B. Chvostek’s sign is associated with hypocalcemia (low calcium levels), not hyperkalemia (high potassium levels).
C. A chest X-ray is not the priority intervention for elevated potassium. The primary concern is the potential for cardiac arrhythmias related to the high potassium level.
D. Hyperkalemia (potassium 6.6 mEq/L) can lead to cardiac arrhythmias. The nurse should obtain a 12-lead ECG to assess for any changes in the heart's electrical activity, which could indicate serious complications like arrhythmias or cardiac arrest.

A. Administer a hypotonic solution B. Administer a vasoconstrictor medication C. Administer an isotonic solution intravenously D. Administer a hypertonic solution intravenously

Correct Answer is C

Explanation

A. Administering a hypotonic solution would not be appropriate in this case. Hypotonic solutions can lower the blood pressure further and worsen the patient’s condition.
B. Administering a vasoconstrictor medication may increase blood pressure, but it is not the first-line treatment for dehydration or volume loss, which seems to be the cause of the patient’s symptoms.
C. Administering an isotonic solution intravenously is the most appropriate intervention. The patient is likely experiencing dehydration and hypotension due to fluid loss from exertion in the sun (possibly heat exhaustion). Isotonic fluids such as normal saline or lactated Ringer's solution are typically used to restore circulating volume and improve blood pressure.
D. Administering a hypertonic solution would be inappropriate, as it could increase the osmolarity of the blood and worsen dehydration, potentially causing fluid shifts that could lead to complications such as cellular dehydration.

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A nurse is monitoring a client receiving an infusion of IV magnesium sulfate. Which of the following findings would indicate to the nurse that the client is experiencing hypermagnesemia?

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