Soru

An obstetrician is called to evaluate a $27$-year-old primigravida at $36$ weeks gestation in the labor and delivery unit due to acute respiratory difficulty. She was admitted four hours ago for preeclampsia with severe features, presenting with a blood pressure of $170/110\text{ mmHg}$, new-onset visual scotomata, and proteinuria. An intravenous magnesium sulfate infusion was initiated for seizure prophylaxis. Over the last $30$ minutes, she has developed significant difficulty swallowing, blurred vision, bilateral ptosis, and profound generalized muscle weakness. Her temperature is $37.0^\circ\text{C}$ ($98.6^\circ\text{F}$), blood pressure is $150/95\text{ mmHg}$, heart rate is $92/\text{min}$, and respiratory rate is $10/\text{min}$ with shallow efforts. Pulse oximetry is $91\%$ on room air. Physical examination reveals weak neck flexion. Patellar reflexes are $2+$ bilaterally. Urine output over the last $4$ hours has been $220\text{ mL}$. Continuous fetal heart rate monitoring demonstrates a baseline of $140/\text{min}$ with moderate variability and no decelerations.

Which of the following is the most appropriate next step in management?