A 19-year-old female, 28 weeks pregnant, presents with severe headache, blurred vision, edema, and tonic-clonic seizures. What should be administered?

The presentation of severe headache, blurred vision, edema, and tonic-clonic seizures in a 28-week pregnant female is highly indicative of eclampsia, which is characterized by the occurrence of seizures in a pregnant woman with preeclampsia. Eclampsia can pose serious risks to both the mother and the fetus, making prompt treatment crucial.

Magnesium sulfate is the treatment of choice for eclampsia due to its neuroprotective properties and its role in controlling seizures. It acts as an anticonvulsant, helping to stabilize the nervous system and reduce the likelihood of further seizures. The administration of magnesium sulfate is essential not only to manage the immediate seizure activity but also to prevent future seizures and complications associated with preeclampsia and eclampsia.

In this context, the other options do not address the immediate and critical need to control seizures or the underlying condition effectively. Calcium gluconate is used primarily as an antidote for magnesium sulfate toxicity and does not have anticonvulsant properties. Atropine is an anticholinergic medication that is typically used in situations like bradycardia and is not appropriate for the management of seizure disorders in pregnancy. Fentanyl, an opioid analgesic,