護理師監測一位因子癲前症接受硫酸鎂（Magnesium Sulfate）點滴輸注的病人。下列哪些發現要求護理師立即停止輸注並通知醫師？（選所有適合的）
The nurse monitors a client receiving magnesium sulfate infusion for preeclampsia. Which finding requires the nurse to stop the infusion immediately and notify the provider? (Select all that apply.)
- ARespiratory rate of 10 breaths per minute✓ 正解呼吸頻率為每分鐘 10 次
- BDeep tendon reflexes are 1+深層肌腱反射為 1+
- CUrine output of 20 mL over the last hour✓ 正解過去一小時的尿液輸出量為 20 mL
- DSerum magnesium level of 6 mEq/L血清鎂濃度為 6 mEq/L
- EAbsence of patellar reflex✓ 正解髕骨反射消失
硫酸鎂的安全管理重點在於監測鎂中毒的早期徵象。鎂是一種中樞神經抑制劑，過量會導致呼吸抑制、神經肌肉反射消失及心搏停止。核心概念是：呼吸速率（低於 12 次/分）、膝反射（消失）、以及尿量（低於 30 mL/hr）。尿量不足至關重要，因為鎂完全由腎臟排泄，尿量減少會導致鎂在體內快速堆積。雖然 1+ 反射代表減弱，但「消失（Absence）」才是更危急的停藥指標。血鎂濃度 6 mEq/L 仍在治療區間（4-7 mEq/L）內，尚未達中毒標準（通常 >8 mEq/L）。臨床安全原則要求在出現生命威脅徵象時先停藥，再給予拮抗劑（葡萄糖酸鈣）。
Safe management of magnesium sulfate centers on monitoring for early signs of toxicity. Magnesium is a central nervous system depressant; excessive levels lead to respiratory depression, loss of neuromuscular reflexes, and cardiac arrest. The core concepts are: respiratory rate (less than 12 breaths/min), patellar reflex (absent), and urine output (less than 30 mL/hr). Inadequate urine output is critical because magnesium is excreted entirely by the kidneys, and decreased output causes rapid accumulation. Although 1+ reflexes are diminished, the 'absence' of reflexes is the more urgent stop-drug criterion. A serum magnesium level of 6 mEq/L remains within the therapeutic range (4–7 mEq/L) and has not reached toxic levels (usually > 8 mEq/L). Clinical safety principles require holding the drug at the first signs of life-threatening changes before administering the antidote (calcium gluconate).
美國 NCLEX 考試中對硫酸鎂中毒的三大標準（呼吸、反射、尿量）考得非常細。台灣臨床端同樣重視這三項監測，但實務上血鎂濃度的監測頻率可能因醫院等級與病情穩定度而異，且護理師在發現反射消失時，必須具備不需先行請示即可停藥的專業判斷能力。