I'm interested in the policy and procedures of Magnesium Sulfate patients care on the post part unit. I would like to know how different facilites treat this situation. Thank you in advance!
We don't get mom's in mag. They have to be off Mag for 12 hours before coming to PP. Once they come to us we just monitor Intake and output for 24 post mag.
At our facility we get PP mag pts. I am fresh out of nursing school and just had a mag pt with crazy BPs (180/100). We get vs q4, if very high BP then more often. We do intake and output, reflexes, and chart how much mag and fluids the mama's have gotten. We usually medicate with labetolol sch and hydrazaline prn for BP more than 150/100 and call MD for possible new parameters are needed.
Hope this answered your question!
Quote from delissiaclark
At our facility we get PP mag pts. I am fresh out of nursing school and just had a mag pt with crazy BPs (180/100). We get vs q4, if very high BP then more often
Wow, that's surprising, but each facility has it's own policies I suppose. I have never worked at a hospital where PP/MB got mag patients, ever. Mag patients always stayed on L&D until the mag was shut off. As for when a patient is on Mag (postpartum), it's still BP q1h, I&O q1h (clear pumps and empty foley), reflexes q2h.
We get mag pp patients all the time.....like we are running a special on hypertension. We get them from L&D on it, and we also start mag on our unit. We do q4 vitals, reflexes, clonus, loc, i&o on our mag moms. And they do not care about acquity...we can have 2 moms on mag or 1 mag mom and 3 couplets. It's all about productivity. It must be a regional thing. I'm in AZ and all the hospitals I have worked at sends mag moms to PP.
We do vitals, DTR's, clonus, and LOC q2 and I&O q4. In L&D they are 1:1 but in PP if we can have 1 other couplet if we have 1 on mag.
Our Mag patients come up to PP as soon as the pressures are stable (systolic <160), which is usually within a few hours of delivery. Our protocol is hourly vitals (not including temp), hourly I&Os (catheter must be left in), hourly LOC/"sedation scale" rating, and check DTRs + clonus q2h. We do couplet care, and we usually won't give someone more than 4 couplets if you have one pt on mag (we try to stick to 3 couplets, but sometimes staffing doesn't allow for it). We try to split up the work by doing all odd hour vitals, and our CNAs do the even hours, although we still check on them at least every hour because only the RN can assess LOC. We usually have PRN IV Labetalol ordered if pressures begin to rise again, and they stay down in L&D if there is any active seizing occurring. I hope this helped =)
Also, I work at the large regional facility in northern Nevada, and from what I've been told, the other hospital is private/for-profit and their mag patients stay in L&D. I think it might have something to do with them being part of the Calofirnia nurse's Union, but I'm not too sure
Q2 vitals, reflexes, and assessment of symptoms (headache, blurry vision, clonus, LOC). Q4 I&O and usually a 1500ml fluid restriction. If you have a mom on Mag they try to give you a lighter assignment (1 other couplet or 2 NICU moms), but when were are busy I have had 4 couplets including at least one on Mag.
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