Mag Sulfate policy

  1. Hi all...

    I am on a committee revising our Mag Sulfate policy or guideline specifically for PIH. We've had issues where the patient is transferred off of our unit to ICU/Telemetry while still on Mag and they have no idea how to run it.

    I'm working with an ICU nurse on this and she wants to put it in a carepath format.

    Can anyone share with me what their facility uses? Also, I'm interests in knowing what type of format you are currently using.

    Thank you!
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    About USA987, BSN

    Joined: Aug '99; Posts: 879; Likes: 76


  3. by   htrn
    We very, very, rarely transfer any of our mom's to ICU. I can see a situation in which we would transfer a mag pt to ICU for further monitoring, but I can almost bet my next paycheck that an OB nurse is going down with her. What specific questions do you have, maybe I'd be able to give you a better answer if I had a few more details.

    Good Luck
  4. by   HappyNurse2005
    Is it standard for you to tx your mag pt's to tele/ICU?
  5. by   LCRN
    As an ICU RN I'd love an OB RN to come down with their patients however it's not realistic with staffing. When we get patient's on mag infusions we check reflexes Q1 and mag levels Q4 usually. We do this while we are addressing their other issues at hand...htn, bleeding, resp insufficiency

  6. by   flytern
    Are you talking before or after delivery?
    Before delivery, pt should be on continuous fetal monitoring.

    After delivery, we have had pt's transferred to ICU, (reluctantly on our part and theirs!) Needless to say, there's many phone calls between the units.
    Our ICU is comfortable about running the Mag, but not comfortable with the post partum aspect.
    We check vitals q1hour/pulse ox, mag levels q6hours, reflexes q1hr.
    We also use electronic charting, so once we set up the careplan in the computer ICU can just continue following it.

    Most of our Mag patients have returned to us with 12 hours.
  7. by   SmilingBluEyes
    We (LDRP unit) manage our PP Mag patients ourselves. We keep the ratio 1:1 or 1:2 MAX....and we do q1hour vital signs, q2h I/O and DTRs til they are off mag.

  8. by   debbiernbsn
    We currently handle Mag patients about like I have read here. My question is though, do you have your patients on telemetry? We do not currently do that, but have heard that the standard of care is going to continuous tele on Mag pts. Do you currently do that or are you thinking of doing that? And what would that entail as far as staffing goes? Any input would be appreciated
  9. by   wwotw
    I can't find anything on the length of time it takes labor to produce that little one after Mag Sulfate is started. Is it really 24-72 hours like I heard in the LDR tonight?
  10. by   mjsobrn
    Hanging Mag on a Sol-u-set tube is something new to us but seems to make sense.. decreases the risk of bolus if the pump malfunctions and if we do transfer it makes the receiving nurse more comfortable knowing that all she/he could give at onetime is usually not enough to do damage.
  11. by   KellNY
    We do vitals (BP and RR) as well as DTRs qhour. Mag level isn't checked routinely, only if there is a reason to do so (lethary, depressed RR, sob, fluid retention, hypotension, etc). Ratios can suck--we might have one mag lady, an induction (cervidil, not pit), plus 4 other pts (take your pick--previas, GD, PPROM, etc), so 1:6 if the unit is full.

    DURING THE BOLUS, I know we do continous EFM, but as far as vitals, I'm not 100% sure, but think it's q15min. Ratios when bolusing, try to keep it 1:1, sometimes 1:2 though.

    We rarely involve ICU.
  12. by   SmilingBluEyes
    I have seen Mag inductions take longer, but we don't let them labor 72 hours. More like 24 max. Esp if membranes ruptured.
  13. by   BirthingBabies
    we keep all of our magnesium mommas here on the floor, before or after delivery. it's actually not uncommon at all for us to have a momma on magnesium after delivery. our policy states that all momma's have a foley and a maintence line besides the mag. we do q 1 hour vital signs and q 2 hour dtr, breath sounds, intake and output, and orientation. we do mag levels q 6 hours.
  14. by   MIA-RN1
    Our PP mag patients and their babies are on our PP floor. We do hourly vitals, reflexes and I/O. They care for their babies as best they can on bedrest, including feeding, holding, etc. No foley--they are allowed bathroom privelidges. Sometimes I will see one walking in the hall with her IV pole but not often. The mag couplet is just figured into our assignments as any other couplet--we usually have four or five couplets or maybe three or four couplets w/ an antpartum or an overflow surgical pt.
    I don't think its safe; mag is scary stuff. They don't check levels unless pt develops sx of mag toxicity. Most of them feel like crap as they get closer to the end of the tx.

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