Giving IV Mg++ Without A Serum Level?

louloubell1 · Jul 23, 2004

In certain situations, most definitely. The most obvious of these situations that comes to mind is during a code where two grams of MgSO4 is a part of the ACLS protocol for torsades de pointes and refractory Vfib.

Leslie1986 · Jul 23, 2004

In certain situations, most definitely. The most obvious of these situations that comes to mind is during a code where two grams of MgSO4 is a part of the ACLS protocol for torsades de pointes and refractory Vfib.

Lou, thank-you so much for your response. What about if the pt. is not monitored, and is stable. Leslie

NeuroICURN · Jul 23, 2004

That depends...what are they in for???? How much Mg are we talking about here??? There's a big difference between giving 2 grams as opposed to, let's say, 6 grams.

But, truth be told, yes, I would be more comfortable in having a serum Mag. level before giving a supplement. It's a simple add on to a BMP...why not just call the lab? It's part of our standard labs.

heartICU · Jul 23, 2004

In most cases, yes, I would feel comfortable giving it without a previous serum level. Magnesium is a relatively safe drug to give...in that I mean that it takes a lot of supplemental magnesium to accumulate to a toxic level. I have often given it without knowing their mag level.

Jailhouse RN · Jul 23, 2004

I agree with RNLou. However it is always best to have the numbers; especially if given as as suppliment.

shinerchia · Jul 23, 2004

i'm just curious what the indication was to give mag like a shot in the dark (malnourished unresponsive pt smells like booze now in a lethal rhythm = 2 grams u bet). stat labs only take minutes....and torsades is really the only indication to give the med without labs (with otherwise stable pt using acls and did you just start tikosyn? or the aforementioned drunk).

would you give:

potassium to a pt without labs...even if he was a gi bleed and pouring out of his chest tubes?....nope.....you'd just be on labs all night and treating numbers and volume.

albumin to a pt without labs or pressures?...umm nope again...lab lab loab only takes a second.

heartICU · Jul 23, 2004

I work in a CTICU and we give Mag to patients who are having frequent PACs, PVCs, or develop atrial fib.

louloubell1 · Jul 23, 2004

Forgot to say that OB nurses would be some good ones to ask about this since mag is a common drug used during premature labor, preeclampsia, etc. I was on mag for quite a long time during my last pregnancy. I was bleeding with placenta previa, and I know when I got my first bolus of mag and was initially started on the drip the labs couldn't have even been back yet. The situation was emergent however, and my baby's life, and my life too, depended on getting that bleeding and contractions stopped.

If there is time, if we are not talking about an emergent situation, then I would say that best practice would dictate getting a mag level first.

shinerchia · Jul 23, 2004

learning the system here...bummer post

shinerchia · Jul 23, 2004

i work in a cticu and we give mag to patients who are having frequent pacs, pvcs, or develop atrial fib.

i fell pretty comfortable with indications, but thanks for the review.

my question is how do i correct a metabolic disorder without objective data. why give mag without knowing a level to a pt with a k of 7.2 (without knowing the level) to correct his ectopy?

my evolving mi pt might need mag...he might need k....he might need dialysis. i'm a lot of things to a lot of people...but i am not psychic. i draw labs when i see changes.

CA CoCoRN, RN · Jul 24, 2004

As an OB nurse, I would/do give Mag without knowing the baseline level before I start it....but it will certainly be in the works having been drawn with the rest of a chem panel. And as soon as I get the level, I'm comparing it to norms and where we want it therapeutically for PTL.

If I've got a pt actively contracting, I'm not going to draw the level, wait for the result, THEN start the gtt. That wait can mean the difference between preterm delivery and staving off further dilatation.

When our pt's are on Mag gtts, their levels are drawn q 6 hr for therapeutic balances and ensuring they don't go into toxicity. DTR, RR, etc. is also a part of hourly assessment of a Mag gtt pt.

Mag is also used for PIH/preeclamptic pt's and the same applies.