Question

You are transporting a 20-year-old pregnant female from a local hospital to a medical facility that specializes in high-risk pregnancies when you note the patient is experiencing unexplained hypotension and bradycardia. The patient has a patent IV and is being administered magnesium that was initiated by hospital staff. On the cardiac monitor, the patient presents with a lengthening PR interval and signs of an impending high-degree nodal block.

Which of the following interventions would be most appropriate in this case?

A) Increase the magnesium sulfate infusion rate, and administer a 1,000 mL normal saline bolus to support the patient's blood pressure
B) Stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity
C) Continue the infusion, but administer potassium chloride to counteract the adverse effects of the magnesium chloride administration
D) Reduce the infusion by half, and administer dextrose 50% to counteract the adverse cardiac effects caused by the magnesium chloride infusion

Answer 1

The most appropriate intervention in this case would be to stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity.

Step-by-step explanation:

The most appropriate intervention in this case would be to stop the magnesium sulfate infusion immediately, and administer the appropriate dose of calcium chloride to correct the adverse effects of magnesium toxicity.

Magnesium sulfate can cause hypotension and bradycardia as side effects. In this scenario, the patient is experiencing unexplained hypotension and bradycardia, along with signs of an impending high-degree nodal block. These symptoms are consistent with magnesium toxicity.

Administering calcium chloride can counteract the adverse effects of magnesium by antagonizing the actions of magnesium on the heart and restoring normal cardiac function.