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Magnesium Sulfate in Pregnancy

Magnesium Sulfate in Pregnancy

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OB Medications (Cheatsheet)

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Outline

Overview

Used as an anticonvulsant in the pregnant patient
1. Decreases risk of preeclampsia from turning into eclampsia
Has been used as a tocolytic, but research shows there are other more effective options
May suppress uterine contractions in the laboring patient

Nursing Points

General

If given in an actively seizing patient, it is an emergency.
1. IV bolus given
2. IM injections
3. Then continuous IV infusion.
Given in a preeclamptic patient to prevent seizure
1. May be continued up to 24 hours postpartum

Assessment

Closely monitor mag levels
1. Normal serum mag level is 1.5-2.5 mEq/L
2. Target therapeutic range for this indication is 2.5-7.5 mEq/L
3. Mag over 12 mEq/L can be fatal
Closely monitor vitals per protocol/order set
1. Hypotension
Closely monitor deep tendon reflexes, respiratory function, heart monitor
1. Patellar reflex = legs hanging over bed, use reflex hammer to hit the quadricep tendon, do it on both legs and rate. Suppressed reflex can be a sign of impending respiratory arrest!
  1. 0 – no response
  2. 1 – sluggish
  3. 2 – normal
  4. 3 – more brisk, slightly hyperactive
  5. 4 – brisk, hyperactive
2. Call if RR is less than 12/min
3. Check RR + reflex before IV doses. Reflex MUST be present and RR greater than 16 before each IV dose (unless hospital policy reflects otherwise).
Watch renal function on BMP or CMP and urinary output (med eliminated by kidneys

Therapeutic Management

Titrating magnesium based on assessment findings
Calcium gluconate easily accessible
1. Antidote for Magsulfate

Nursing Concepts

Pharmacology
Lab values
Safety

Patient Education

Side effects

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Concepts Covered:

Gastrointestinal
Newborn Complications
Pregnancy Risks
Labor Complications
Fetal Development
Terminology
Prenatal Concepts
Noninfectious Respiratory Disorder
Newborn Care
Labor and Delivery
Postpartum Care
Postpartum Complications
Medication Administration
Studying
Communication

Study Plan Lessons

05.03 Jaundice for CCRN Review

Abortion in Nursing: Spontaneous, Induced, and Missed

Abruptio Placenta for Certified Emergency Nursing (CEN)

Abruptio Placentae (Placental abruption)

Acyclovir (Zovirax) Nursing Considerations

Addicted Newborn

Adult Vital Signs (VS)

Alpha-fetoprotein (AFP) Lab Values

Ampicillin (Omnipen) Nursing Considerations

Anemia in Pregnancy

Antepartum Testing

Antepartum Testing Case Study (45 min)

Anti-Infective – Aminoglycosides

Anti-Infective – Lincosamide

Aspiration for Certified Emergency Nursing (CEN)

Behind The Red Line – Live Tutoring Archive

Betamethasone and Dexamethasone

Betamethasone and Dexamethasone in Pregnancy

Bicarbonate (HCO3) Lab Values

Blood Glucose Monitoring

Blood Transfusions (Administration)

Body System Assessments

Butorphanol (Stadol) Nursing Considerations

Cardiac (Heart) Disease in Pregnancy

Causes of Chorioamnionitis Nursing Mnemonic (Pregnancies Are Very Interesting)

Causes of Labor Dystocia Nursing Mnemonic (Having Extremely Frustrating Labor)

Causes of Postpartum Hemorrhage Nursing Mnemonic (4 T’s)

Certified Nurse Midwife

Chorioamnionitis

Clindamycin (Cleocin) Nursing Considerations

Congestive Heart Failure (CHF) Labs

Day in the Life of a Labor Nurse

Day in the Life of a Postpartum Nurse

Dexamethasone (Decadron) Nursing Considerations

Direct Bilirubin (Conjugated) Lab Values

Discomforts of Pregnancy

Disseminated Intravascular Coagulation (DIC)

Diuretics (Loop, Potassium Sparing, Thiazide, Furosemide/Lasix)

Ectopic Pregnancy

Ectopic Pregnancy Case Study (30 min)

Ectopic Pregnancy for Certified Emergency Nursing (CEN)

Emergent Delivery (OB) (30 min)

Emergent Delivery for Certified Emergency Nursing (CEN)

Episiotomy – Evaluation of Healing Nursing Mnemonic (REEDA)

Erythroblastosis Fetalis

Eye Prophylaxis for Newborn

Eye Prophylaxis for Newborn (Erythromycin)

Factors That Can Put a Pregnancy at Risk Nursing Mnemonic (RIBCAGE)

Family Planning & Contraception

Family Planning & Signs of Pregnancy – Live Tutoring Archive

Fertilization and Implantation

Fetal Alcohol Syndrome (FAS)

Fetal Circulation

Fetal Development

Fetal Distress Interventions Nursing Mnemonic (Stop MOAN)

Fetal Environment

Fetal Heart Monitoring (FHM)

Fetal Heart Monitoring Like A Pro – Live Tutoring Archive

Fetal Heart Monitoring Like A Pro 2 – Live Tutoring Archive

Fetal Wellbeing Assessment Tests Nursing Mnemonic (ALONE)

Fundal Height Assessment for Nurses

Furosemide (Lasix) Nursing Considerations

Gestation & Nägele’s Rule: Estimating Due Dates

Gestational Diabetes (GDM)

Gestational Diabetes and Why YOU Should Know About It – Live Tutoring Archive

Gestational HTN (Hypertension)

Glucagon Lab Values

Glucose Tolerance Test (GTT) Lab Values

Gravidity and Parity (G&Ps, GTPAL)

HELLP Syndrome – Signs and Symptoms Nursing Mnemonic (HELLP)

Hematomas in OB Nursing: Causes, Symptoms, and Nursing Care

Hemoglobin A1c (HbA1C)

Hemorrhage (Postpartum Bleeding) for Certified Emergency Nursing (CEN)

Hepatitis B Vaccine for Newborns

Homocysteine (HCY) Lab Values

Hydatidiform Mole (Molar pregnancy)

Hydralazine (Apresoline) Nursing Considerations

Hydrochlorothiazide (Hydrodiuril) Nursing Considerations

Hyperbilirubinemia (Jaundice)

Hyperemesis Gravidarum

Hyperemesis Gravidarum for Certified Emergency Nursing (CEN)

Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)

Hypovolemic Shock Case Study (OB sim) (60 min)

Incompetent Cervix

Infections in Pregnancy

Initial Care of the Newborn (APGAR)

Inserting a Foley (Urinary Catheter) – Female

Intra Uterine Device – Potential Problems Nursing Mnemonic (PAINS)

Isotonic Solutions (IV solutions)

Labor Progression Case Study (45 min)

Leopold Maneuvers

Lung Surfactant

Lung Surfactant for Newborns

Magnesium Sulfate

Magnesium Sulfate

Magnesium Sulfate (MgSO4) Nursing Considerations

Magnesium Sulfate in Pregnancy

Maternal Risk Factors

Mechanisms of Labor

Meconium Aspiration

Meds for Postpartum Hemorrhage (PPH)

Meds for PPH (postpartum hemorrhage)

Menstrual Cycle

Methylergonovine (Methergine) Nursing Considerations

Newborn of HIV+ Mother

Newborn Physical Exam

Newborn Reflexes

Nifedipine (Procardia) Nursing Considerations

Nursing Care Plan (NCP) for Abortion, Spontaneous Abortion, Miscarriage

Nursing Care Plan (NCP) for Abruptio Placentae / Placental abruption

Nursing Care Plan (NCP) for Chorioamnionitis

Nursing Care Plan (NCP) for Diabetes Mellitus (DM)

Nursing Care Plan (NCP) for Dystocia

Nursing Care Plan (NCP) for Ectopic Pregnancy

Nursing Care Plan (NCP) for Gestational Diabetes (GDM)

Nursing Care Plan (NCP) for Gestational Hypertension, Preeclampsia, Eclampsia

Nursing Care Plan (NCP) for Hyperemesis Gravidarum

Nursing Care Plan (NCP) for Hypertension (HTN)

Nursing Care Plan (NCP) for Incompetent Cervix

Nursing Care Plan (NCP) for Mastitis

Nursing Care Plan (NCP) for Maternal-Fetal Dyad Using GTPAL

Nursing Care Plan (NCP) for Meconium Aspiration

Nursing Care Plan (NCP) for Neonatal Jaundice | Hyperbilirubinemia

Nursing Care Plan (NCP) for Newborns

Nursing Care Plan (NCP) for Placenta Previa

Nursing Care Plan (NCP) for Postpartum Hemorrhage (PPH)

Nursing Care Plan (NCP) for Premature Rupture of Membranes (PROM) / Preterm Premature Rupture of Membranes (PPROM)

Nursing Care Plan (NCP) for Preterm Labor / Premature Labor

Nursing Care Plan (NCP) for Process of Labor

Nursing Care Plan (NCP) for Transient Tachypnea of Newborn

Nursing Care Plan for (NCP) Fetal Alcohol Syndrome (FAS)

Nursing Care Plan for Newborn Reflexes

Nursing Case Study for Maternal Newborn

Nutrition Assessments

Nutrition in Pregnancy

Nutritional Requirements

OB (Labor) Nurse Report to OB (Postpartum) Nurses

OB Course Introduction

OB Non-Stress Test Results Nursing Mnemonic (NNN)

OB Pharm and What Drugs You HAVE to Know – Live Tutoring Archive

Obstetric Trauma for Certified Emergency Nursing (CEN)

Obstetrical Procedures

Opioid Analgesics in Pregnancy

Oral Birth Control Pills – Serious Complications Nursing Mnemonic (Aches)

Oxytocin (Pitocin) Nursing Considerations

Pediatric Vital Signs (VS)

Physiological Changes

Phytonadione (Vitamin K)

Phytonadione (Vitamin K) for Newborn

Placenta Previa

Placenta Previa for Certified Emergency Nursing (CEN)

Possible Infections During Pregnancy Nursing Mnemonic (TORCH)

Post-Partum Assessment Nursing Mnemonic (BUBBLE)

Postpartum Discomforts

Postpartum Hematoma

Postpartum Hemorrhage (PPH)

Postpartum Interventions

Postpartum Physiological Maternal Changes

Postpartum Thrombophlebitis

Precipitous Labor

Preeclampsia (45 min)

Preeclampsia, Eclampsia, and HELLP Syndrome for Certified Emergency Nursing (CEN)

Preeclampsia: Signs, Symptoms, Nursing Care, and Magnesium Sulfate

Pregnancy Outcomes Nursing Mnemonic (GTPAL)

Preload and Afterload

Premature Rupture of the Membranes (PROM)

Preterm Labor for Certified Emergency Nursing (CEN)

Probable Signs of Pregnancy Nursing Mnemonic (CHOP BUGS)

Process of Labor

Process of Labor – Mom Nursing Mnemonic (4 P’s)

Process of Labor – Baby Nursing Mnemonic (ALPPPS)

Process of Labor – Live Tutoring Archive

Process of Labor 2 – Live Tutoring Archive

Prolapsed Umbilical Cord

Promethazine (Phenergan) Nursing Considerations

Prostaglandins in Pregnancy

Protein (PROT) Lab Values

Retinopathy of Prematurity (ROP)

Rh Immune Globulin (Rhogam)

Rh Immune Globulin in Pregnancy

Signs of Pregnancy – Live Tutoring Archive

Signs of Pregnancy (Presumptive, Probable, Positive)

Spironolactone (Aldactone) Nursing Considerations

Stages of Fetal Development Nursing Mnemonic (Proficiently Expanding Fetus)

Terbutaline (Brethine) Nursing Considerations

Threatened/Spontaneous Abortion for Certified Emergency Nursing (CEN)

Tips & Advice for Newborns (Neonatal IV Insertion)

Top 5 Misunderstood OB Concepts – Live Tutoring Archive

Transient Tachypnea of Newborn

Umbilical Cord Vasculature Nursing Mnemonic (2A1V)

Uterine Stimulants (Oxytocin, Pitocin)

Uterine Stimulants (Oxytocin, Pitocin) Nursing Considerations

VEAL CHOP Nursing Mnemonic (Fetal Accelerations and Decelerations) (VEAL CHOP)

What the Heck is Antepartum Testing? – Live Tutoring Archive