Soru

A primigravid patient at $37$ weeks of gestation is currently in the labor and delivery unit. She was admitted $24$ hours ago for induction of labor due to preeclampsia with severe features. She is receiving continuous intravenous oxytocin, labetalol, and magnesium sulfate. Over the past $4$ hours, her total urine output has been $45\text{ mL}$. The nurse calls the physician because the patient has become increasingly somnolent and difficult to arouse. Current vital signs are temperature $37.1^\circ\text{C}$ ($98.8^\circ\text{F}$), blood pressure $135/85\text{ mmHg}$, pulse $82/\text{min}$, and respiratory rate $8/\text{min}$. Oxygen saturation is $90\%$ on room air. Neurologic examination reveals absent deep tendon reflexes at the patella and biceps. The continuous fetal heart rate tracing demonstrates a baseline of $145/\text{min}$, minimal variability, and no decelerations. Which of the following is the most appropriate initial step in management?