Unique Plan Description: OB Magnesium Sulfate
Plan Selection Display: OB Magnesium Sulfate
PlanType: Medical                                 
Version: 3          
Begin Effective Date: 2022-10-20 08:55:25
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2022-10-20 08:59:24
Available at all facilities: No

OB Magnesium Sulfate Protocal
Medications

OB Seizure Prophylaxis
Laboratory
	Magnesium Level
		T;N, Routine, Q6H, spec type = Blood
IV Solutions
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	magnesium sulfate 4gm in 100mL water
		4 gm, IVPB, Once, 200 ml/hr
			Comment: 4 gm in 100 mL water, infuse over 30 minutes
	magnesium sulfate 6gm/D5W 100mL (JE)
		6 gm, INT, IVPB, Once, 200 ml/hr, T;N
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	magnesium sulfate 20 gm in 500 mL water Premix IV
		500 mL, IV
			Comment: 1 gm/hr = 25 mL/hr1.5 gm/hr = 37.5 mL/hr2 gm/hr = 50 mL/hr2.5 gm/hr = 62.5 mL/hr3 gm/hr = 75 mL/hr
		20 gm, EVERY BAG, 2 gm/hr
	Lactated Ringers Injection
		1,000 mL, IV, 75 ml/hr
			Comment: Adjust rate so LR and Magnesium Sulfate TOTAL fluid intake is 125ml/hr.
Medications
	calcium gluconate
		1 gm, Solution, IV Push, Q5MIN, PRN, absence of deep tendon reflexes
			Comment: Flush IV line before administering. May give 1gm IV Push over 5 minutes (max rate: 200mg/min). Administer in large vein to decrease risk of thrombophlebitis and extravasation. May repeat as necessary. Patient must be placed on telemetry if this drug is administered.
Patient Care
	Notify MD
		T;N, If Serum magnesium level greater than 8 and Discontinue Magnesium Maintenance IV stat
		T;N, If O2 sat less than 95%
		T;N, If respiration less than 12, patient still pregnant
		T;N, If DTRs absent
	Discontinue IV
		T;N, If serum magnesium greater than 8mg/dL, Once

Fetal Neuroprotection
Laboratory
	Magnesium Level
		T;N, Routine, Q6H, spec type = Blood
IV Solutions
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	magnesium sulfate 4gm in 100mL water
		4 gm, IVPB, Once, 200 ml/hr
			Comment: 4 gm in 100 mL water, infuse over 30 minutes
	magnesium sulfate 4gm in 100mL water (WH/FH)
		4 gm, Injection-Premix, IVPB, Once, infuse over 20 min(s), T;N
			Comment: Give both 4gm and 2gm to get 6gm dose, infuse both bags in 35 minutes.
	magnesium sulfate 2gm in 50mL water
		2 gm, Injection-Premix, IVPB, Once, T;N, Infuse Over: 15 min(s)
			Comment: Give both 4gm and 2gm to get 6gm dose, infuse both bags in 35 minutes.
	magnesium sulfate 6gm/D5W 100mL (JE)
		6 gm, INT, IVPB, Once, 200 ml/hr, T;N
		<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.0 Transitional//EN"><HTML><HEAD><META content="text/html; charset=windows-1252" http-equiv=Content-Type><STYLE> BODY background-color: rgb(224,224,224);margin:0; P margin:0 </STYLE><META name=GENERAT(NOTE)*
	magnesium sulfate 20 gm in 500 mL water Premix IV
		500 mL, IV
			Comment: 1 gm/hr = 25 mL/hr1.5 gm/hr = 37.5 mL/hr2 gm/hr = 50 mL/hr2.5 gm/hr = 62.5 mL/hr3 gm/hr = 75 mL/hr
		20 gm, EVERY BAG, 2 gm/hr
	Lactated Ringers Injection
		1,000 mL, IV, 75 ml/hr
			Comment: Adjust rate so LR and Magnesium Sulfate TOTAL fluid intake is 125ml/hr
Medications
	calcium gluconate
		1 gm, Solution, IV Push, Q5MIN, PRN for absence of deep tendon reflexes
			Comment: Flush IV line before administering. May give 1gm IV Push over 5 minutes (max rate: 200mg/min). Administer in large vein to decrease risk of thrombophlebitis and extravasation. May repeat as necessary. Patient must be placed on telemetry if this drug is administered.
Patient Care
	Notify MD
		T;N, If O2 sat less than 95%
		T;N, If Serum magnesium level greater than 8
		T;N, If respiration less than 12
		T;N, If DTRs absent
	Discontinue IV
		T;N, If serum magnesium greater than 8mg/dL, Once

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase