What information should be included in the client and family teaching of magnesium sulfate? Select all that apply.

1. Monitoring deep tendon reflexes

2. Assessing urine output every 8 hours

3. Maintaining a dark, quiet environment

4. Using a pump to regulate the medication

5. Having calcium gluconate available at the bedside

6. Notifying the care provider if the respiratory rate is slower than 20 breaths/min

The correct answers are options 1. "Monitoring deep tendon reflexes", 3. "Maintaining a dark, quiet environment", 4. "Using a pump to regulate the medication", and 5. "Having calcium gluconate available at the bedside".

Explanation:

The most common cause of a patient receiving magnesium sulfate is as a treatment for severe preeclampsia. The client and family teaching of magnesium sulfate must include learning about the interventions that are needed for this treatment, including:

- "Monitoring deep tendon reflexes". A signal of magnesium sulfate toxicity is the loss of deep tendon reflexes. These reflexes must be monitored for security reasons.

- "Maintaining a dark, quiet environment". The patient must be kept in a dark, quiet environment as neuromuscular stimulation must be limited.

- "Using a pump to regulate the medication". The doses of magnesium sulfate must be regulated to avoid toxicity, therefore an injection pump must be used.

- "Having calcium gluconate available at the bedside". Calcium gluconate is used to treat magnesium sulfate toxicity. This medication must be kept available at the bedside for any situation of emergency.