Basics
Name one indication for Magnesium?
Pre-eclampsia/eclampsia, neuroprotection, tocolysis
What is a common side effect?
Flushing
Loss of which reflex indicates toxicity?
Deep tendon reflexes
How often are VS during loading dose?
Every 15 minutes
What is the standard loading dose?
4-6gm
How is Magnesium excreted?
Kidneys
What vision change may occur?
Blurred vision
What is dangerous RR threshold?
Less than 16 breaths/min
What is the O2 monitoring requirement during the loading dose?
Continuous
How long is the loading dose administered?
4 gms- 20 minutes
6 gms- 30 minutes
What is considered normal Magnesium levels?
5-7.9 mg/dL
What is a GI symptom?
Nausea/Vomiting
What is a concerning O2 Sat?
less than 94%
How often do you auscultate breath sounds after the 2nd hour?
Every 2 hours
What is the standard maintenance dose?
2 gms/hr
What does Magnesium do to contractions?
Decreases frequency and force
General feeling patients report?
Lethargy, flu-like feeling
What is a concerning amount of urine for a patient on Magnesium?
less than 30ml/hr
How often is level of consciousness monitored after the 2nd hour?
Every 4 hours
When would you decrease the maintenance dose to 1g/hr
If urine output less than 400ml/24h, urine less than 30ml/h, any signs of toxicity
How does Magnesium work?
Causes direct inhibition of action potentials in the myometrial muscle cells, which decreases the frequency and force of contractions.
Anticonvulsant
Electrolyte replenisher in treatment of pre-eclampsia/eclampsia
What is another side effect?
Sweating
What is the antidote and dose for magnesium?
Calcium Gluconate 1gm IV over 3 minutes
How often is urine monitored after the 2nd hour?
Foley catheter- every hour
Voiding-every 4 hours
How must Magnesium be given?
IV on an infusion pump