مريضة على كبريتات المغنيسيوم، وتنفسها ١٠، ومنعكس الركبة غائب. ما التصرف الأول؟

A woman on magnesium sulphate has RR 10 and absent knee reflexes. What is the first action?

1. Encourage sleep because she is comfortable
2. Stop the infusion and notify the physician
3. Give an extra magnesium bolus
4. Increase the rate to prevent seizures

Answer: B) Stop the infusion and notify the physician. Absent reflexes and slow breathing are signs of magnesium toxicity. Stop the infusion, notify the physician, prepare calcium gluconate and support breathing.