Mg order

[Hobbs]

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If you were told to give 3g of mag and give it over the next 3 hours iv, what would the order look like. This is not a trick question, I just don't understand how to write orders for mixing things into iv solutions.

The nurse said, mag sulfate 3g 250cc/3 hours.

Hobbs

 

[Lizard1]

looks fine to me. usually though you can just write "infuse 3g MgSO4 IV over 3 hours" and the pharmacy will take it from there - at worst call you to confirm the plan

however, just an fyi, in most cases you can push slowly 2 or 3 grams of MgSO4 instead of running it an hr per gm. heck, IIRC, OB's load 4gm of MgSO4 and then start an infusion of 1-2gm per hr

hope this helps

 

[maxnm]

When in doubt call the pharmacy. They always seem happy to help with stuff like that.

 

[Blade28]

Per JCAHO rules, we're not allowed to abbreviate mag sulfate as MSO4 (gets confused with morphine).

I just write:

Magnesium sulfate 3g IV x1

And the nurses figure out the rest.

 

[gutonc]

When in doubt call the pharmacy. They always seem happy to help with stuff like that.

I finally learned this rule at about 2:30 this morning, on my 2nd o/n call in the MICU. I really got a pass the first night with the resident watching everything I did, this time (different resident), he just let me run and man did I flail. The only things that saved me were an understanding pharmacist and a well utilized text paging system. This way, i got a page that said, "I think you meant to write for X for Pt. Jones when you should have written Y, please confirm." When I had a second I called, said "yes" and signed the verbal order given to the RN by pharmacy whenver I got around to that chart next. After the 4th page, I decided a pre-emptive strike was in order and just called and asked how I should write the PPI drip and which PPI was in season at the moment. 15 seconds later I had the order written correctly and my acute GIB was tucked in w/ lansoprazole and a few dozen units, blissfully unaware of the 2 cameras that awaited her in the morning.

Moral of the story, Pharmacy is your friend. They'd rather you wrote your orders correctly the first time and are almost always happy to help you do that. A strong, experienced RN can be a huge help in these cases as well.

BE (now PE)

 

[caroladybelle]

If you were told to give 3g of mag and give it over the next 3 hours iv, what would the order look like. This is not a trick question, I just don't understand how to write orders for mixing things into iv solutions.

The nurse said, mag sulfate 3g 250cc/3 hours.

Hobbs

Unfortunately, it depends on the facility and the unit, and often what kind of access that the patient has. That is why it is best to ask the nurse or the pharmacy specific to the unit.

Heck, I would probably write it for you, and have you sign it, if permitted by policy. But some places have that "MD must write/enter all orders.

Quite frankly, if you write it incorrectly for the unit/facility protocols, either the pharmacy/nurse will automatically correct for it, or call you for a "clarification" and suggest the appropriate wording.

On my unit, with a higher RN to patient ratio, all patients with a double lumen central access, and many on tele, it would be 3g in 100mL NS over 90 minutes or faster if there is emergent circumstances w/ tele in use. On a regular medsurg, with PIVs, 3g in 250mL NS over 2-3hours.

cc is one of the abbreviations facing elimination in handwritten orders.

 

[Blade28]

Yeah, cc should be eliminated by now, along with qd, U, MgSO4, levo, etc.

 

[DOtobe]

We have electronic order entry in my hospital, and this is one of the reasons it is so great. We don't have to worry about how to write things; the computer does it for us.

But we are lost when the computers are down and we have to write orders

 

[Hobbs]

thanks to all....
have been on call in SICU last 36, away from computer. 🙂

Hobbs