During the administration of magnesium sulfate for severe pre-eclampsia, what should the nurse monitor closely?

Monitoring neurological status is crucial during the administration of magnesium sulfate, especially in the context of severe pre-eclampsia. This is because magnesium sulfate is primarily used to prevent seizures, which can occur due to the high blood pressure associated with pre-eclampsia. A change in neurological status could indicate the onset of seizures or worsening of the patient's condition, necessitating immediate medical intervention.

Close observation of neurological status helps the nurse to identify any potential complications early, such as magnesium toxicity, which can lead to severe side effects that impact consciousness and reflexes. Assessing the patient's level of consciousness, orientation, and any seizure activity can provide critical information regarding the effectiveness of the magnesium sulfate treatment and the overall stability of the patient's condition.

While monitoring heart rate irregularities and fluid intake and output can be significant in other contexts, the most direct and critical concern in this scenario relates to the potential for seizures and changes in neurological function. Signs of infection are also important but not as immediately critical to the administration of magnesium sulfate in this specific setting.