一位子癇前症的病人正在接受硫酸鎂（Magnesium Sulfate）點滴輸注。護理師首要監測哪項評估指標？
A client is receiving an infusion of magnesium sulfate for preeclampsia. Which assessment finding is the priority for the nurse to monitor?
- AFrequency of uterine contractions子宮收縮的頻率
- BSerum magnesium level every 6 hours每 6 小時測量血清鎂濃度
- CBlood glucose level血糖值
- DPresence of deep tendon reflexes✓ 正解深層肌腱反射的存在與否
硫酸鎂（Magnesium Sulfate）主要用於子癇前症（Preeclampsia）的癲癇預防。其治療範圍與中毒劑量相當接近（狹窄治療窗），當血中鎂離子濃度過高時，首要且最敏感的臨床指標為深部肌腱反射（Deep Tendon Reflexes, DTRs）減弱或消失，接著才是呼吸抑制。監測反射是床邊護理安全的最優先事項。
Deep tendon reflexes are the priority assessment because their loss is the earliest sign of magnesium sulfate toxicity, which has a narrow therapeutic window. Monitoring reflexes allows for immediate intervention before more severe complications like respiratory depression occur. While serum levels are important, clinical signs at the bedside take precedence for safety.
在美國臨床實務中，護理師需嚴格執行每小時監測 DTRs、呼吸速率及尿量（通常需大於 30mL/hr）。若出現反射消失或呼吸小於 12 次/分，必須立即停藥並通知醫師，同時備妥解毒劑葡萄糖酸鈣（Calcium Gluconate）。