What should a nurse monitor closely in a client receiving magnesium sulfate?

When a client is receiving magnesium sulfate, it is crucial for the nurse to closely monitor respiratory function due to the potential for respiratory depression. Magnesium sulfate is often used in obstetric care, particularly to manage conditions like preeclampsia and to prevent seizures. However, high levels of magnesium can depress the central nervous system and subsequently affect respiratory function.

Monitoring respiratory function allows the nurse to detect signs of respiratory distress early, such as decreased respiratory rate, shallow breathing, or changes in oxygen saturation. A respiratory rate of less than 12 breaths per minute may indicate a critical level of magnesium and requires immediate intervention.

While monitoring fluid intake is important, as magnesium sulfate can lead to fluid overload, and serum potassium levels are relevant in assessing potential electrolyte imbalances, the most immediate and life-threatening risk associated with magnesium sulfate therapy is respiratory compromise. Neurological status is also monitored, but respiratory function takes priority in this context because of the direct effects of magnesium on respiratory muscles.