Purpose of the tool: This tool describes the key perinatal safety elements with examples for the safe administration of magnesium sulfate during labor. The key elements are presented within the framework of the Comprehensive Unit-based Safety
Program (CUSP). Who should use this tool: Nurses, physicians, midwives, pharmacists, and other labor and delivery (L&D) unit staff responsible for the preparation and administration of magnesium sulfate during labor. How to use this tool: Review the key perinatal safety elements with L&D leadership and unit staff to determine how the elements will be implemented on your L&D unit. Consider any existing facility policies or processes related to magnesium sulfate use. Consider using preprinted orders, standing orders, and staff training to support implementation. A sample of how some of these key perinatal safety elements can be incorporated into a unit approach to safe magnesium sulfate administration is provided in the Appendix of this tool. Key Perinatal Safety Elements
References
AppendixEvery effort was made to ensure the accuracy and completeness of this resource. However, the U.S. Department of Health and Human Services makes no warranties regarding errors or omissions and assumes no responsibility or liability for loss or damage resulting from the use of information contained within. SAMPLE Safe Medication Administration Process for Magnesium Sulfate(References are located in the reference list above.)
Page last reviewed November 2018 Page originally created April 2017 Internet Citation: Safe Medication Administration: Magnesium Sulfate. Content last reviewed November 2018. Agency for Healthcare Research and Quality, Rockville, MD. What is the therapeutic blood level for magnesium sulfate?The range of serum magnesium levels considered therapeutic (4–7 mEq/L) was achieved by only 5 patients submitted to the 2-gram/hour regimen.
What is a therapeutic serum magnesium level?Serum magnesium level of 2.0–3.5 mmol/L is considered therapeutic by several authors [8,9,10,11,12,13,14].
What should I monitor during magnesium infusion?Monitor for signs and symptoms of magnesium sulfate toxicity (ie. hypotension, areflexia (loss of DTRs), respiratory depression, respiratory arrest, oliguria, shortness of breath, chest pains, slurred speech, hypothermia, confusion, circulatory collapse).
What labs do you monitor for magnesium sulfate?Magnesium levels must be monitored frequently by checking serum levels every 6 to 8 hours or clinically by checking patellar reflexes or urinary output.
What assessments are most important for a patient receiving magnesium sulfate?Vital signs (blood pressure, respirations [rate and pattern], pulse, temperature, oxygen saturation level). DTRs and presence or absence of clonus.
What is the primary indication for the administration of magnesium sulfate to the patient with severe preeclampsia?Hyperreflexia was the main indication to start magnesium sulphate treatment (75%).
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