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Discussion

MgSO4 question

OK, this question was on my test today, if pt is 6 hrs after delivery had +1 DTR what would you do? Would you call physician to get a lower dose, or stop the Mag and call the doctor?

Isn't +1 hyporelfexia; which is a sign of mag toxicity?

what would you have picked?

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    NINDS scale for tendon reflex assessment

    Reflex absent = 0

    Reflex small, less than normal; includes a trace response, or a response brought out only by reinforcement = 1

    Reflex in lower half of normal range = 2

    Reflex in upper half of normal range = 3

    Reflex enhanced, more than normal; includes clonus if present, which can be noted in an added description of the reflex = 4

    Note. From “NINDS Myotatic Reflex Scale,” by M. Hallett, Neurology,

    43, p. 2723. Copyright 1993 by the National Institutes of

    Health. Reprinted with permission.

    http://cmapspublic.ihmc.us/rid=1190392629982_1846239176_11875/0884217504263145.pdf

    Page 225 of the article (it starts with page 221 and runs through page 230) gives you details on DTR and Magnesium administration.

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    I dont think that I would stop the mag. I would first look at other nurses assessments to see if DTR's were at +1 earlier. If so than that is not a change. Also look at the patient is she alert or drowsy? How are her respirations? Then taking everything into consideration I may call the doctor if needed. Just remember some patients reflexes are +1. Hope that helps.

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