Download Total IV fluids not to exceed 3 liters per 24 hours UMC MAGNESIUM

Patient Label Here
UMC MAGNESIUM SULFATE ADMINISTRATION
ORDERS FOR FBC/FCU
1.
Attending Physician:_________________________________________ Resident/Fellow_______________________________
2.
Diagnosis:_______________________________________________________________________________________________
3.
Co-Morbidities: __________________________________________________________________________________________
4.
Allergies:
5.
NURSING:
 NKDA
 Allergic to: ___________________________________________________________________
 Temperature every 4hrs  VS and DTR’s every 15 minutes times 1 hour, then every 30 minutes times 2 hours, then every
hour. Notify MD if______________________________________________________________________________________
 Intake and output
 Hourly
 Other: _____________________________
 Insert Foley Catheter and daily Foley Care. Notify MD if urine output less than 30 ml per hour
 Diet:
 NPO  Other______________________________________________________________________________
 Activity:  Bedrest  Decreased Stimuli Limit visitors
 Treatments:
 Initiate seizure precautions
 Continuous Electronic Fetal Monitoring if undelivered
6.
LABORATORY/DIAGNOSTICS:
 CBC with differential  CMP  Uric Acid  ALT  AST  PT  PTT  Fibrinogen
 Repeat above check labs every 12 hours
 Magnesium levels: 2-3 hours after the start of the magnesium infusion, then every 6 hours (Notify MD of magnesium level <
4mg/dl or > 8.4 mg/dl or signs and symptoms of toxicity)
 Notify MD of any abnormal lab results
 OTHER:________________________________________________________
 OTHER:________________________________________________________
7.
IV:
 Continuous IV fluids: Lactated Ringers to run at ________________________ml/hr
Total IV fluids not to exceed 3 liters per 24 hours
8.
MEDICATIONS: Refer also to Admission Medication Reconciliation Form
 Magnesium Sulfate: 50 grams in 400ml of 0.45% Normal Saline (Total Volume 500 ml)
Loading Dose: _______grams IVPB over 20-30 minutes via infusion pump
Maintenance Dose: _________Grams per hour IVPB via infusion pump
(A loading dose of 4-6 grams with a maintenance dose of 2-3 grams per hour is recommended
unless renal function is impaired or weight of the patient is less than 45kg)
 Calcium Gluconate 1 gram IV as needed for magnesium toxicity
 TO  Read back
Order taken by Signature: ________________________________________Date/Time: _____________________________
Physician Signature__________________________________________ Date/Time_____________________________
Page 1 of 1- UMC Mag Sulfate for FBC/FCU Orders 11/8/2011 (#963 R-1)