Unformatted text preview: ACTIVE LEARNING TEMPLATE: Medication Edison Macias
MEDICATION___________________________________________________________________________ REVIEW MODULE CHAPTER__9__________
_____________________________________________________________________ PURPOSE OF MEDICATION Expected Pharmacological Action
Magnesium prevents or controls convulsions by blocking neuromuscular
transmission and decreasing the amount of acetylcholine liberated at the
end plate by the motor nerve impulse. It has a depressant effect on the
central nervous system (CNS), but it does not adversely affect the woman,
fetus or neonate when used as directed in eclampsia or pre-eclampsia. Therapeutic Use
Used for immediate control of life-threatening convulsions in the treatment of
severe toxemias (pre-eclampsia and eclampsia) of pregnancy ,and in the
treatment of acute nephritis in children. Also indicated for replacement therapy
in magnesium deficiency, especially in acute hypomagnesemia accompanied
by signs of tetany similar to those of hypocalcemia. Also used in uterine tetany
as a myometriat relaxant. Complications
- Intravenous use beyond 5 to 7 days can cause fetal abnormalities.
- Continuous IV infusion, especially more than 24 hours before delivery, can result
in magnesium toxicity, including neuromuscular or respiratory depression, in the
If plasma magnesium rises above 10 mEq/liter: respiratory paralysis and heart
block can occur. Medication Administration
1. Start mainline intravenous access with #18 IV catheter.
2. Infuse magnesium sulfate as ordered by provider.
Ensure compatibility of all other IV medications with
3. Seizures/HTN (adults) 1g q6 4 doses as needed (IM, IV)
4 Pre-eclampsia and Eclampsia( IV, IM)
4-5g by IV infusion, concurrently with up to 5g IM in each
buttock, then 4-5g IM q4 or 4g by IV infusion followed by
1-2 g/h continuous infusion ( not to exceed 40 g/d or 20
g/48h in the presence of fever renal insufficiency Contraindications/Precautions
Should not be administered parenterally in patients with heart block or myocardial damage.
May be harmful if swallowed.
May act as an irritant.
Adverse reactions include hypotension, ECG changes, diarrhea, urinary retention, CNS depression
and respiratory depression.
Avoid use in the 2 hours before delivery unless it is the only therapy available for eclamptic seizures.
Monitor fetal heart rate. Interactions
A total of 315 drugs (1228 brand and generic names) are
known to interact with magnesium sulfate
May potentiate calcium channel blockers and
neuromuscular blocking agents. Nursing Interventions
1. Monitor fetal well-being
2. Assess physical and mental status of patient.
Any change in alertness may be a very important
finding indicating central nervous system
irritability or depression.
3. Provide quiet environment when feasible.
4. Position patient on side as much as possible,
discourage emi-fowler’s position for extended
periods of time.
5. Obtain hourly intake/output (or as ordered by
physician). Client Education
Evaluation of Medication Effectiveness Normal serum magnesium levels, control of seizures
associated with toxemias (pre-eclampsia and eclampsia)
of pregnancy. ACTIVE LEARNING TEMPLATES Explain rationale to patient and support
persons with the use of this medication.
Explain that the efficacy and safety for
pregnant women has not been
established, and that use beyond 5 to 7
days can cause fetal abnormalities.
teach avoid foods high in sodium, avoid
alcohol and limit caffeine, and increase
fluid intake to 8 glasses per day. Therapeutic Procedure A7 ...
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