A mother is on anticonvulsant therapy with magnesium sulfate for severe pre- eclampsia. During the course her Pulse rate was 62/min Diastolic blood pressure was 100mmHg respiratory rate was 15/min and urine output was 20 ml per hour over preceding four hours. On physical examination, her patellar reflex is absent. Which management is the most appropriate for this case? a. Change the drug to diazepam b. Providing calcium gluconate c. Resuscitating the mother d. Continue administering magnesium sulfate

Question

A mother is on anticonvulsant therapy with magnesium sulfate for severe pre- eclampsia. During the course her Pulse rate was 62/min Diastolic blood pressure was 100mmHg respiratory rate was 15/min and urine output was 20 ml per hour over preceding four hours. On physical examination, her patellar reflex is absent. Which management is the most appropriate for this case? a. Change the drug to diazepam b. Providing calcium gluconate c. Resuscitating the mother d. Continue administering magnesium sulfate

Answer 1

The most appropriate management for this case is option b. Providing calcium gluconate.In this scenario, the mother is on anticonvulsant therapy with magnesium sulfate for severe pre-eclampsia. The absence of the patellar reflex indicates magnesium toxicity. The symptoms of magnesium toxicity include loss of patellar reflex, respiratory depression, hypotension, and bradycardia. In this case, the mother's pulse rate is low (62/min), diastolic blood pressure is 100 mmHg, respiratory rate is 15/min, and urine output is low (20 ml per hour over the preceding four hours). These signs suggest magnesium toxicity.Calcium gluconate is the antidote for magnesium toxicity. It works by counteracting the effects of magnesium on the heart and muscles. Administering calcium gluconate will help to reverse the signs of magnesium toxicity and stabilize the mother's condition.Option a, changing the drug to diazepam, is not appropriate in this situation. Diazepam is another anticonvulsant medication and would not address the magnesium toxicity.Option c, resuscitating the mother, may be necessary if the mother's condition deteriorates and she goes into cardiac arrest or respiratory failure. However, the first step should be to provide calcium gluconate to reverse the magnesium toxicity.Option d, continuing to administer magnesium sulfate, is not appropriate in this situation. Continuing the magnesium sulfate would further increase the risk of magnesium toxicity and worsen the mother's condition.In conclusion, the most appropriate management for this case is to provide calcium gluconate to reverse the magnesium toxicity and stabilize the mother's condition.

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