_06153_magnesium_sulfate_orders

_06153_magnesium_sulfate_orders - STAT MEDICATION Date:...

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Unformatted text preview: STAT MEDICATION Date: ______________ Time: ______________ Allergies: _____________________________________________________________________________ 1. Loading Dose: Infuse Magnesium Sulfate 40gm in 1000mL H20 at ________ gm over ________ minutes by infusion pump. 2. Other _____________________________________________________________________________ 3. Maintenance Dose: Infuse Magnesium Sulfate at ____________ gm/hour. 4. Mainline IV 1000mL __________ at __________ mL/hour by infusion pump. 5. PRN IV Site Change. 6. Vital Signs/Loading Dose: Temp, BP, heart rate, RR, DRT’s before infusion begins, then BP, heart rate, RR every 10 minutes while infusing loading dose, then at one and two hours following completion of loading dose. 7. Vital Signs/Maintenance Dose: Assess and document BP, heart rate and respiratory rate every 4 hours. 8. Keep I&O record. • If indwelling catheter in place, notify M.D. if urine output is less than 30mL/hour. • If patient is voiding, notify M.D. if urine output is less than 200 mL in 6 hours. 9. 10. Notify MD if signs of Magnesium toxicity are present: RR less than 12/min and/or non-responsive to verbal stimulation and moderate tactile stimulus, and/or bradycardia (less than 60 bpm). Notify MD if contractions increased to equal or greater than 6 /hours. 11. STAT Serum Magnesium level for signs of toxicity. Call physician with results. 12. Acetaminophen 1000mg PO Q 4 hrs PRN for headaches, not to exceed 4 grams in 24 hours. 13. Maalox 30mL PO Q 2 hours PRN heartburn. 14. Metoclopramide (Reglan) 10mg IV Q 4 hours PRN for nausea. _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________________________________________ Physician Signature _______________________________________________________________________________ Authorization for therapeutic substitution is given unless checked here ZZ06153 (8/19/05) Patient Identification SAFH SDH SMCS SRMC Magnesium Sulfate Orders YELLOW - CHART WHITE - NURSING/SCAN TO PHARMACY ORDERS SCANNED TO PHARMACY STAT MEDICATION Date: ______________ Time: ______________ Allergies: _____________________________________________________________________________ 1. Loading Dose: Infuse Magnesium Sulfate 40gm in 1000mL H20 at over ________ minutes by infusion pump. 2. Other 3. Maintenance Dose: Infuse Magnesium Sulfate at 4. Mainline IV 1000mL 5. PRN IV Site Change. 6. Vital Signs/Loading Dose: at gm gm/hour. mL/hour by infusion pump. Temp, BP, heart rate, RR, DRT’s before infusion begins, then BP, heart rate, RR every 10 minutes while infusing loading dose, then at one and two hours following completion of loading dose. 7. Vital Signs/Maintenance Dose: Assess and document BP, heart rate and respiratory rate every 4 hours. 8. Keep I&O record. • If indwelling catheter in place, notify M.D. if urine output is less than 30mL/hour. • If patient is voiding, notify M.D. if urine output is less than 200 mL in 6 hours. 9. 10. Notify MD if signs of Magnesium toxicity are present: RR less than 12/min and/or non-responsive to verbal stimulation and moderate tactile stimulus, and/or bradycardia (less than 60 bpm). Notify MD if contractions increased to equal or greater than 6 /hours. 11. STAT Serum Magnesium level for signs of toxicity. Call physician with results. 12. Acetaminophen 1000mg PO Q 4 hrs PRN for headaches, not to exceed 4 grams in 24 hours. 13. Maalox 30mL PO Q 2 hours PRN heartburn. 14. Metoclopramide (Reglan) 10mg IV Q 4 hours PRN for nausea. Physician Signature _______________________________________________________________________________ Authorization for therapeutic substitution is given unless checked here ZZ06153 (8/19/05) Patient Identification SAFH SDH SMCS SRMC Magnesium Sulfate Orders YELLOW - CHART WHITE - NURSING/SCAN TO PHARMACY ORDERS ...
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