Question

A practitioner orders magnesium sulfate to be infused at 4 g in 20 minutes as a loading dose, followed by a maintenance intravenous infusion of 2 g/hour.

1. Identify the guidelines that must be followed when administering magnesium sulfate intravenous piggy-back.
2. Explain the expected therapeutic effect of magnesium sulfate to the patient.
3. List maternal-fetal assessments that should be done on a regular basis during the infusion of magnesium sulfate.
4. Identify the signs of magnesium sulfate toxicity

Answer 1

1. The guidelines to be followed are:
The patient should be monitored carefully.
Injection Calcium Gluconate should be ready in hand.
Renal function test to be done
Check for blood pressure, respiratory rate and deep tendon reflexes.
Check for side effects and signs of magnesium sulphate toxicity.
2. The expected therapeutic effects are: Anticonvulsant, CNS and respiratory depressant, vasodilator.
3. The following is assessed in newborn:
Levels of calcium - Low levels of calcium and osteopenia or fractures in the baby
Levels of magnesium- Hypermagnesemia
Fetal abnormalities
Respiratory status: Neuromuscular and respiratory depression in detus
Muscular system status: Hypotonia
Blood pressure: Hypotension
Skeletal system: Congenital rickets
In mother:
Assess for uterine contraction as it causes decreased contractions.
Check for blood pressure, heart rate and muscle strength.
Check for magnesium and calcium levels.
4. The signs of magnesium sulphate toxicity are:
Nausea and vomiting
Diarrhoea
Lethargy
Muscle weakness
Irregular heart beat
Low blood pressure
Urine retention
Respiratory distress
Cardiac arrest.