3. Administration When bolus is complete, initiate a premixed maintenance bag with a (cont'd) concentration of 20 grams of per 500 ml. Administer maintenance infusion at a rate of (check one)— ___1 gram/hour (25 ml/hour) ___1.5 grams/hour (38 ml/hour) ___2 grams/hour (50 ml/hour) ___Other (separate provider order required for rates other than the above rates) the magnesium sulfate line with appropriate medication sticker. Do not infuse other medication into the magnesium sulfate line. Second must verify pump settings and line hookup whenever there is a rate change or a new bag is hung. When the order for magnesium is discontinued, the pump should be stopped and the bag and IV tubing promptly disconnected from the patient and discarded. 4. Provider Notify the primary maternity care provider if any of the following notification conditions occur: parameters and changes from baseline more than 20 mmHg SBP or 10 mmHg standing orders DBP mmHg for responding pulse >120 bpm or < 60 bpm to suspected respiration < 14 or > 24 magnesium oxygen saturation < 95% toxicity urine output less <30 ml/hour increasing proteinuria increasing clonus DTRs 4+ persistent headache or visual disturbances increasing swelling of face, hands, or feet presence/worsening of epigastric (right upper quadrant pain) increasing nausea/vomiting bruising vaginal bleeding Activate a response AND notify the primary maternity care provider for— signs and symptoms of magnesium toxicity seizure Signs and symptoms of magnesium toxicity include respiratory depression (less than 12 respirations/minute), prolonged expiration, severe chest heaviness or shortness of breath, a significant decrease in the level of consciousness, the absence of deep tendon reflexes, and a significant decrease in the patient’s pulse or blood pressure.
3. Administration (cont'd) When bolus is complete, initiate a premixed maintenance bag with a concentration of 20 grams of per 500 ml. Administer maintenance infusion at a rate of (check one)— ___1 gram/hour (25 ml/hour) ___1.5 grams/hour (38 ml/hour) ___2 grams/hour (50 ml/hour) ___Other (separate provider order required for rates other than the above rates) the magnesium sulfate line with appropriate medication sticker. Do not infuse other medication into the magnesium sulfate line. Second must verify pump settings and line hookup whenever there is a rate change or a new bag is hung. When the order for magnesium is discontinued, the pump should be stopped and the bag and IV tubing promptly disconnected from the patient and discarded. 4. Provider notification parameters and standing orders for responding to suspected magnesium toxicity Notify the primary maternity care provider if any of the following conditions occur: changes from baseline more than 20 mmHg SBP or 10 mmHg DBP mmHg pulse >120 bpm or < 60 bpm respiration < 14 or > 24 oxygen saturation < 95% urine output less <30 ml/hour increasing proteinuria increasing clonus DTRs 4+ persistent headache or visual disturbances increasing swelling of face, hands, or feet presence/worsening of epigastric (right upper quadrant pain) increasing nausea/vomiting bruising vaginal bleeding Activate a response AND notify the primary maternity care provider for— signs and symptoms of magnesium toxicity seizure Signs and symptoms of magnesium toxicity include respiratory depression (less than 12 respirations/minute), prolonged expiration, severe chest heaviness or shortness of breath, a significant decrease in the level of consciousness, the absence of deep tendon reflexes, and a significant decrease in the patient’s pulse or blood pressure.
tool_safe-mgso4.docx