Focused_Review(4).pdf - ACTIVE LEARNING TEMPLATE Medication...

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Unformatted text preview: ACTIVE LEARNING TEMPLATE: Medication Edison Macias STUDENT NAME______________________________________ Magnesium Sulfate MEDICATION___________________________________________________________________________ REVIEW MODULE CHAPTER__9__________ CATEGORY CLASS__D _____________________________________________________________________ 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 newborn. 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 magnesium sulfate 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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