🧪 Magnesium Sulfate: NCLEX Guide to Use, Toxicity, and Reflex Checks

Magnesium sulfate is one of the most tested OB meds on NCLEX — and also appears in seizure protocols and cardiac contexts.
Most frequently, it’s used to prevent seizures in preeclampsia.

The NCLEX loves testing:

• Toxicity signs

• Reflex checks

• Magnesium lab levels

• The antidote

📊 Magnesium Sulfate Quick Facts

Use	Prevent seizures in preeclampsia/eclampsia
Therapeutic Range	4–7 mEq/L
Toxic Level	>7 mEq/L
Antidote	Calcium Gluconate
Excretion	Renal — monitor urine output
Signs of Toxicity	↓ DTRs, ↓ RR, ↓ LOC, hypotension, lethargy
Nursing Checks	Check DTRs, ensure RR >12, and urine output >30 mL/hr

🧠 NCLEX Tip: Always Check Reflexes Before the Next Dose

• Deep tendon reflexes (DTRs) are the earliest sign of magnesium toxicity

• Absent patellar reflex = HOLD the next dose

🩺 Nursing Interventions

• Check reflexes every 1–2 hours

• Monitor RR and urine output closely

• Have calcium gluconate at bedside

• Avoid magnesium with CNS depressants

• Educate patient to report blurred vision, trouble breathing, weakness

💡 Mnemonic: “M-A-G”

M – Monitor reflexes, respirations, urine
A – Antidote = Calcium gluconate
G – Give slowly via IV pump (NEVER IV push)

📲 Study OB Pharmacology with King of the Curve

• 👶 Preeclampsia case simulations

• ⚠️ Toxicity ID flashcards

• 📊 Weekly pharmacology review games

Start now at kingofthecurve.org/studyscience

🏁 Final Thoughts

Magnesium sulfate is powerful — and dangerous if not monitored carefully. The NCLEX wants to know if you can recognize the subtle signs of toxicity and act early.

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