[mark_LD_RN]

another question
if you got a patient on mag who just delivered and mag is infusing at 50cc an hour, and you have a limit of 150cc's an hour total for iv fluids. how do you mix your pit and at what rate do you give it.?

a nurse here had mixed it 30 of pit in 500 cc of LR at rate of 50 cc an hour. one nurse went around ranting and raving that it was to concentrated and dangerous.

personally I have seen it given this way many times. what do you think?

[OBNurseShelley]

I guess everybody does it different, but where I work, mag at 50cc hour would be 5g, so we never give that much, it's usually at 20cc/hour which is 2g/hour....so we dont' worry about our pit too much, especially after delivery, their fluid balance is off a little anyway, cuz of blood loss......i might run in half a bag of 1000cc with 20u pitocin........

[SmilingBluEyes]

At the one hospital I work, We mix our pit this way: 15 units in 250cc D5W........there is always a bag of LR/NS as a main line which literally does not run when the pit is high, but there nonetheless for safety and if other meds must be given in the same IV (you can flush, you know)....with 250cc, you go up 1 unit, 1 cc. It decreases fluid load this way.

Yes, You can also reconfigure the amt of MGSO4 in the bag, so as to run at a slower rate.......but that must be done w/pharmacy consultation and doctor orders, of course. That it is more concentrated does not bother me if you are running it at the ***proper rate** and do not plan to BOLUS it!

At the other hospital I work we do 20U in 1L LR......it can get tricky, for sure. I like the 15 U in 250cc method better. But then I believe the MGSo4 is mixed differently. I have to check now, I forget! anyhow, there are two suggestions.

[luv l&d]

We usually run mag at 50cc/hr and then make up the rest with what ever else we need. Most of the time we put 20u of pitocin in a liter, but sometimes the docs order 30u/liter, so we run the pit at 100cc/hr to make the 150cc/hr. Have NEVER seen 30 in 500, would think that could be dangerous, but talk about afterpains!!! Cruel and unusual punishment!!!

[luv l&d]

Of course I forgot to say that all are on pumps.

[RNMom1969]

At my place, pit is always 10units in 100cc LR and mag 40gm in 1000cc LR. So, 50cc/hr=2gm........opening the pit at delivery is safe and done often here. 30 units in 500? That seems to be an awful lot. Can't say I've ever seen that done here. Many times docs will ask for 20 units in 1000 if bleeding is an issue. If fluid overload is a real concern (...and if they're on mag....DUH!), well, everything will be on pumps to keep careful I&O's.....does this even answer your question? lol....kinda got lost here!
Joyce

[heyabo]

We use MagSo4 at a ratio of 1gm/10cc so we are only running that at 20cc/hr and we use 10 units in 500cc/hr so there's not really a problem with overloading. I've never seen 30 units in 500cc but we willuse 20 units in 500 as needed.