نفاس مصابة بتسمم الحمل على سلفات المغنيسيوم. تنفسها ١٠ بالدقيقة، ومنعكسات الركبة غائبة، والبول ٢٠ مل بالساعة. ما أول إجراء؟

A postpartum client with pre-eclampsia on magnesium sulfate has RR 10/min, absent patellar reflexes and urine output 20 mL/h. What is the first action?

1. Continue; these effects are expected
2. Give a diuretic to clear magnesium faster
3. Increase the magnesium rate to prevent seizures
4. Stop it, prepare calcium gluconate, notify provider

Answer: D) Stop it, prepare calcium gluconate, notify provider. These are signs of magnesium toxicity (absent reflexes, RR under 12, oliguria): stop the infusion; the antidote is calcium gluconate.