- Body system
- Fluids and electrolytes
- Antidote or reversal
- Calcium gluconate IV; keep it at the bedside.
- Therapeutic level
- Seizure prevention in preeclampsia: commonly about 4.8 to 8.4 mg/dL (4 to 7 mEq/L).
What is Magnesium sulfate used for?
- Seizure prevention in severe preeclampsia and treatment of eclampsia
- Hypomagnesemia
- Torsades de pointes
- Fetal neuroprotection before early preterm birth
- Severe asthma exacerbation (adjunct)
How Magnesium sulfate works
Central nervous system depressant that blocks neuromuscular transmission and calcium entry; replaces magnesium.
Common side effects
- Flushing, warmth and sweating
- Drowsiness
- Hypotension
- Muscle weakness
Report right away
- Trouble breathing, extreme drowsiness or slurred speech
Nursing considerations for Magnesium sulfate
- High-alert medication: give by infusion pump, with an independent double check. The loading dose and maintenance infusion often come from separate premixed bags.
- Signs of toxicity: loss of deep tendon reflexes (usually the earliest sign), respiratory rate below 12, urine output below 30 mL per hour, decreasing level of consciousness. Stop the infusion and notify the prescriber.
- Assess reflexes, respirations, oxygen saturation, urine output and level of consciousness often; magnesium is excreted by the kidneys.
- A commonly cited therapeutic range for seizure prevention is about 4.8 to 8.4 mg/dL (4 to 7 mEq/L).
Patient teaching
- You may feel hot and flushed during the infusion.
- Tell the nurse right away if you have trouble breathing or feel very weak.
This card does not list doses. Use the prescriber's order, the product label and a current drug reference for dosing, and follow your facility's policies.
Electrolyte replacements practice questions
NCLEX-style questions on the class Magnesium sulfate belongs to.
3 questions. Choose an answer to see the rationale.
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Which order for potassium chloride should the nurse question?
Show answer
Answer C: 20 mEq IV push IV push potassium can cause cardiac arrest. Potassium is always diluted and infused.
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During a magnesium sulfate infusion, the patient's patellar reflexes are absent. What should the nurse do?
Show answer
Answer B: Stop the infusion and notify the provider Loss of deep tendon reflexes is an early sign of magnesium toxicity.
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Which medication should be at the bedside during a magnesium sulfate infusion?
Show answer
Answer B: Calcium gluconate Calcium gluconate is the antidote for magnesium toxicity.
Frequently asked questions
What is Magnesium sulfate used for?
Seizure prevention in severe preeclampsia and treatment of eclampsia; Hypomagnesemia; Torsades de pointes; Fetal neuroprotection before early preterm birth.
What drug class is Magnesium sulfate?
Magnesium sulfate belongs to the class electrolyte replacements. Central nervous system depressant that blocks neuromuscular transmission and calcium entry; replaces magnesium.
What are the nursing considerations for Magnesium sulfate?
High-alert medication: give by infusion pump, with an independent double check. The loading dose and maintenance infusion often come from separate premixed bags. Signs of toxicity: loss of deep tendon reflexes (usually the earliest sign), respiratory rate below 12, urine output below 30 mL per hour, decreasing level of consciousness. Stop the infusion and notify the prescriber.
What should patients report while taking Magnesium sulfate?
trouble breathing, extreme drowsiness or slurred speech.
What is the antidote for Magnesium sulfate?
Calcium gluconate IV; keep it at the bedside.