If a patient receiving magnesium sulfate shows sedation and decreased level of consciousness, what is the nurse's next appropriate action?

• A. Discontinue magnesium sulfate and notify the provider
• B. Increase the magnesium infusion rate
• C. Assess for sedation and decreased level of consciousness
• D. Administer a stimulant

Answer: (C)

When a patient on magnesium sulfate shows sedation and decreased level of consciousness, the priority is to assess for possible magnesium toxicity. These signs can indicate that the levels are high enough to depress the CNS and respiratory drive, so you need a focused check of the patient’s status before changing therapy. Quickly assess airway and breathing (respiratory rate, rhythm, oxygen saturation), vital signs, level of consciousness, and deep tendon reflexes; review the infusion rate and recent magnesium level if available. This assessment helps you gauge the urgency and plan the next steps.

If the assessment suggests toxicity, the next actions would be to stop the magnesium sulfate and notify the provider, with preparations for possible antidotal treatment. Increasing the infusion or giving a stimulant would worsen the situation and are not appropriate first moves.