Final answer:
Following administration of a magnesium sulfate IV bolus, a nurse should monitor for respiratory paralysis, as it's a potential adverse effect due to the drug's depressant effects on the neuromuscular system.
Step-by-step explanation:
After the administration of magnesium sulfate 1g IV bolus, a nurse should monitor the client for several potential adverse effects. Given the options provided, the correct answer is respiratory paralysis. Magnesium sulfate is a central nervous system depressant and can cause diminished reflexes if levels become too high. While hyperkalemia affects the muscular and nervous systems, leading to potential muscle weakness and cardiac issues, and hypercalcemia leads to underactive nervous system responses, magnesium acts differently. A high level of magnesium can suppress neuromuscular function and lead to shallow breathing or in severe cases, respiratory paralysis.
Potential signs of magnesium toxicity also include low blood pressure, lethargy, and urine retention. Since hyperkalemia may result in symptoms like mental confusion and weakened respiratory muscles, it provides a useful comparison for understanding the neuromuscular effects of magnesium sulfate overdose. However, unlike hyperkalemia, magnesium sulfate toxicity would not typically cause hyperreflexia or increased blood pressure, which are not associated with the depressant effects of magnesium on neuromuscular function.