Which substance must a nurse ensure is available at the bedside when administering magnesium sulfate to a client with pre-eclampsia?

When administering magnesium sulfate, especially in the context of treating pre-eclampsia, it's crucial to have calcium gluconate readily available. Magnesium sulfate is used to manage and prevent seizures in women with pre-eclampsia due to its ability to act as a central nervous system depressant. However, one of the significant side effects of magnesium sulfate administration is the risk of respiratory depression and decreased reflexes, which can lead to serious complications.

Calcium gluconate serves as a specific antidote to counteract the effects of magnesium sulfate toxicity. If the client experiences symptoms such as decreased respiratory rate, diminished reflexes, or other signs of toxicity, administering calcium gluconate can help restore normal physiological function by re-establishing calcium levels that may be suppressed by high magnesium levels. This makes having calcium gluconate at the bedside an essential safety measure during the administration of magnesium sulfate.