امرأة على تسريب كبريتات المغنيسيوم لتسمم الحمل. بعد ٦ ساعات: التنفس ٩، ومنعكس الركبة غائب، والبول ١٨ مل/ساعة، وهي نعسانة. ما الإجراء الأول؟

A woman is on a magnesium sulfate infusion for pre-eclampsia. After 6 hours: RR 9, absent patellar reflexes, urine 18 mL/h and drowsiness. What is the first action?

1. Monitor every 4 hours as usual
2. Give oral fluids to improve urine output
3. Increase the rate to prevent the next seizure
4. Stop the infusion and prepare calcium gluconate

Answer: D) Stop the infusion and prepare calcium gluconate. Low respirations, absent reflexes and oliguria indicate magnesium toxicity. Stop the infusion, support breathing and give calcium gluconate as the antidote as ordered.