Page 862 - Saunders Comprehensive Review For NCLEX-RN

the obstetrician (OB).
4. Always administer by IV infusion via an infusion
monitoring device; carefully monitor the dose being
administered, and follow agency protocol for
administration.
5. Keep calcium gluconate readily accessible in case of a
magnesium sulfate overdose, because calcium
gluconate antagonizes the effect of magnesium
sulfate.
6. Monitor deep tendon reflexes hourly for signs of
developing toxicity.
7. Test the patellar reflex or knee jerk reflex before
administering a repeat parenteral dose (used as an
indicator of central nervous system depression;
suppressed reflex may be a sign of impending
respiratory arrest) (Table 28-2).
8. Patellar reflex must be present and respiratory rate
must be greater than 12 breaths per minute (or as
designated by agency protocol) before each parenteral
dose.
9. Monitor intake and output hourly; output should be
maintained at 25 to 30 mL/hr because the medication
is eliminated through the kidneys.

Monitor a client receiving magnesium sulfate intravenously

closely for signs of toxicity. Call the OB if respirations are less than 12
breaths per minute, indicating respiratory depression, or if any other
adverse effects occur.
III. Betamethasone and Dexamethasone

A. Description: Corticosteroids that increase the production

of surfactant to accelerate fetal lung maturity and reduce the
incidence or severity of respiratory distress syndrome
B. Use: For a client in preterm labor between 28 and 32

weeks’ gestation whose labor can be inhibited for 48 hours
without jeopardizing the mother or fetus
C. Adverse effects and contraindications
1. May decrease the mother’s resistance to infection
2. Pulmonary edema secondary to sodium and fluid
retention can occur.
3. Elevated blood glucose levels can occur in a client with
diabetes mellitus.
D. Interventions
1. Monitor maternal vital signs and lung sounds, and for
edema.

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