Magnesium sulphate (MgSO4) is the drug choice for?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2018

Explanation

Magnesium sulphate (MgSO4) is the primary medication used for the prevention and treatment of seizures in women with eclampsia and severe pre-eclampsia.
It functions as a central nervous system depressant and anticonvulsant by blocking neuromuscular transmission and decreasing the amount of acetylcholine released at the motor endplate.
This action raises the seizure threshold, making it effective in managing the convulsive episodes characteristic of eclampsia.

Option A: Magnesium sulphate is absolutely contraindicated in patients with Myasthenia Gravis.
Option B: Impaired renal function is a condition that requires extreme caution and dose adjustment for MgSO4, not an indication for its use.
Option D: Respiratory failure is a life-threatening sign of magnesium sulphate toxicity, not an indication for its use.

Clinical Relevance

Nursing practice connection: Knowing Indication for Magnesium Sulphate (MgSO4) administration helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
A nurse's primary responsibility during MgSO4 administration is vigilant monitoring for signs of toxicity. This includes checking deep tendon reflexes (patellar reflex), respiratory rate, and urine output before every dose.
The antidote, Calcium Gluconate, must always be readily available at the bedside whenever a patient is receiving a magnesium sulphate infusion.
What if? If the patient's respiratory rate drops to 10 breaths/min and the patellar reflex is absent, the nurse's immediate actions are to stop the MgSO4 infusion, notify the physician, and prepare to administer intravenous calcium gluconate to reverse the toxic effects.

How to Approach the Question

First, identify the core of the question: What is the primary use of Magnesium Sulphate (MgSO4)?
Recall the major indications and contraindications for common obstetric medications.
Evaluate Option C: Eclampsia. Remember that eclampsia is characterized by seizures in pregnancy, and MgSO4 is the first-line anticonvulsant for this condition.
Evaluate the other options as contraindications or adverse effects. Myasthenia gravis is a classic contraindication due to the risk of muscle weakness. Impaired renal function increases toxicity risk. Respiratory failure is a sign of overdose.
Conclude that Eclampsia is the only valid indication among the choices.

Concept Tested & Keywords

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E6 Obstetrics Williams p. 31-51

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