The anti-convulsant mechanism of magnesium is believed to depress seizure of the
foci in the brain and peripheral neuromuscular blockade.
antagonist for mag sulfate
Calcium Gluconate is the antidote for magnesium toxicity
who is mag sulfate given to and why?
pregnant clients with preeclampsia (AKA PIH-pregnancy induced hypertension)
to prevent seizures.
when should mag sulfate be held
when client’s RR or U/O falls or reflexes are diminished or absent
what are signs of impending magnesium toxicity, or excess magnesium
flushing or feeling warm AEB central nervous system depression
these s/s are due to excessive magnesium sulfate.
flushing or feeling warm
what are nursing considerations for mag sulfate
1. RR must be at least 14breaths/minute
2. DTR must be present
3. U/O must be at least 30ml/hour
4. Serum Mg+ level betw 4-8mEq/dL
what is the loading dose for mag sulfate
4 grams in 1L NSS
what is the maintenance dose for magnesium sulfate
2 grams in 1L NSS
s/s of gestational hypertension
epigastric pain
blurred vision
H/A
why is magnesium sulfate the drug of choice for gestational hypertension
b/c it reduces edema by shifting from extracellular space into the intestines
when does RH isoimmunization occur in pregnant clients
when the Rh(+)fetal blood cells cross into the maternal circulation and stimulate maternalantibody production
what is the general idea of Rh factor
Generally, during pregnancy a few of the baby’s blood cells manage to escape into the mom’s circulation, and mom develops antibodies that treat baby as an intruder
administer _______ if mom is Rh(-) and baby is Rh(+)
Rhogam 300mcg IM
when should MMR vaccine be administered
when rubella is non immune
drug indicated for inducing labor by stimulating contractions.
oxytocin (pitocin)
nursing intervention for oxytocin
Monitor fetal heart tones and mommy laying on L side
when should oxytocin infusion be stopped
when contractions are strong for 60seconds or it could rupture the uterus
why should I & O's be monitored with oxytocin
because oxytocin can cause WATER INTOXICATION, possibly leading to seizure, coma and death.
what kind of effect does oxytocin produce
antidiuretic effect
when bleeding is controlled what should be done with oxytocin
discontinue
what is the dose for oxytocin to control uterine bleeding
•20 unitsin 1L LR at 125ml/hr
1 unit of pitocin = how many millunits
1000
this is administered when client is displaying early amniotic fluid leakage with uterine irritability with rapid contractions to ultimately REDUCE UTERINE MOTILITY
terbutaline (brethine)
when is terbutiline administered
if client is preterm and displaying rapid contractions
how much terb should be administered
SQ route 0.25mg
common SE of terb
fluttering or tight sensation in the chest
majr adverse effect of epidural
hypotension
major nursing intervention for epidural hypotension
give 500 ml fluid bolus to help prevent hypotension.
how should gentamycin and rocephin be given
IVPB
ampicillin _____ grams IV in LD Dept
2
ampicillin ______ grams IV in OB dept
1
demarol narcotic is given what route
IM
route for stadol narcotic
IM or IVPB
a clients labor does not progress what should be given