What signs would concern you for magnesium toxicity in a patient receiving magnesium sulfate?

In considering signs of magnesium toxicity in a patient receiving magnesium sulfate, hyperreflexia is a significant concern. Magnesium sulfate is often used as a tocolytic agent or to prevent seizures in conditions like preeclampsia and eclampsia. Monitor reflexes is part of the management because magnesium acts as a neuromuscular blocker. Under normal conditions, a patient should exhibit normal reflexes, and hyperreflexia, which indicates heightened reflex responses, may suggest that the magnesium level is approaching toxicity. This condition can lead to serious complications such as respiratory depression, cardiac arrest, and neurological impairments if not addressed promptly.

The other choices, while relevant in clinical settings, do not directly indicate magnesium toxicity. Severe headache may suggest other conditions such as worsening hypertension or tension but is not a classic sign of magnesium toxicity. Shortness of breath could indicate a respiratory issue or heart problem but would not specifically suggest magnesium toxicity. Decreased fetal movement is concerning for fetal distress but again does not point directly to magnesium toxicity itself. Monitoring for hyperreflexia is crucial as it serves as an immediate indicator of toxicity and necessitates prompt clinical intervention to prevent serious complications.