The perinatal nurse, in collaboration with physicians, can use deep tendon reflexes as a powerful tool in determining the need to start, adjust, or stop magnesium infusion. Toxicity can be detected using physical manifestations as a guide. Clinical signs may be a better indicator than serum levels of tissue levels of magnesium. Whether magnesium is given to prevent seizures or for tocolysis, patients in both situations are at risk for developing toxicity and must be assessed regularly to ensure patient safety.

Deep tendon reflexes (DTRs) demonstrate the homeostasis between the cerebral cortex and the spinal cord. When these reflexes are disrupted, hyperreflexia (disease induced) or hyporeflexia/areflexia (drug induced) occurs. Although nurses perform DTR assessment regularly, it is difficult to incorporate theoretical principles in these assessments because of scant medical literature, a lack of nursing research, and time constraints in nursing programs. These conditions usually result in one-on-one training, causing reduced consistency. A comprehensive examination assists the clinician to apply theoretical principles, develop expert technique, and serve as a catalyst for clinical research.