NURSI 1230 magnesium sulfate concept map

Indications:
 Central Nervous System depressant used as an
anticonvulsant effect for preeclampsia (prevention of
Concept map for Magnesium Sulfate
eclamptic seizures)
 Tocolytic agents for premature labor (Procardia
works better for this with less side effects) Dosage:
 Neuro protection for preterm
Used Antenatal, Intrapartal and Postpartum
 transient decrease in BP
IV loading dose is 4-6 g over 15-30 minutes.
(Not therapeutic as an antihypertensive agent)
Followed by maintenance dose of 2 g/ hr IV per pump

Administered for up to 24-48 hours post-partum (still at
risk for eeclamptic seizure)
Side effects:

 Peripheral vasodilatation → patient becomes “overheated” →
flushing (provide ice packs to axilla to cool down)
 Potential headache
Nursing Interventions:
 Diaphoresis
 Lethargy  Monitor for s/s of mag toxicity
 Nausea and vomitting
 Respirations > 16 (Respiratory status is the
 Blurred vision
highest priority)
 Apply pulse oximetry
 Oxygen saturation < 95% (pulse ox)
 Slurred speech
Significant Labs:  Chest pain
 Monitor for decreased fetal heart rate
Clinical findings Serum Magnesium level variability
 Assess Deep tendon reflexes (<=+1-0
Normal (without treatment) 1.5-2 mE/L
indicates toxicity)
Therapeutic level 4-7 mE/L  Assess urine output (>30 ml/hour)
 Safety: Have the antidote calcium gluconate
EKG changes 5-10 mE/L at bedside
 Keep room quiet and lights dimmed