Final answer:
The nurse should immediately notify the provider if the client has a respiratory rate of 10/min, as this could indicate respiratory depression, a side effect of magnesium sulfate and a sign of magnesium toxicity. Nausea and feeling flushed are less concerning side effects, and a urinary output of 40 mL/hr is low but may not be immediately alarming without other symptoms.
Step-by-step explanation:
A nurse caring for a client at 30 weeks of gestation who has a prescription for magnesium sulfate IV should notify the provider if they observe any adverse effects, especially those affecting the patient's vital signs and overall stability. Among the options provided, the most concerning adverse effect that warrants immediate notification of the provider is a respiratory rate of 10/min. Magnesium sulfate is used to treat preterm labor, and while it can be effective, it can also have significant side effects if levels become too high or if the patient has an abnormal response. The nurse should monitor the patient for signs of magnesium toxicity, which primarily include respiratory depression, loss of deep tendon reflexes, and altered mental status. A respiratory rate of 10/min indicates potential respiratory depression, a serious side effect, and could be a sign of magnesium toxicity.
While nausea and feeling flushed could be associated with magnesium sulfate administration, they are usually not as immediately life-threatening as respiratory depression. A urinary output of 40 mL/hr is at the lower limit of normal (usually evaluated as 30 mL/hr or more as acceptable), but the provider should be informed if there's a downward trend or other concerning symptoms present. The priority, however, is ensuring the patient's airway and breathing are adequate since these are critical life functions.