Unique Plan Description: OB Preterm Labor
Plan Selection Display: OB Preterm Labor
PlanType: Medical                                 
Version: 1          
Begin Effective Date: 2011-11-22 14:58:26
End Effective Date: 2100-12-31 00:00:00
Last Updated Date: 2021-12-21 10:24:14
Available at all facilities: Yes

OB Preterm Labor
Laboratory
	Magnesium Level
		T;N, Routine, Q6H, spec type = Blood
IV Solutions
		Mag Sulfate Bolus(NOTE)*
	magnesium sulfate 6gm/D5W 100mL (JE)
		6 gm, INT, IVPB, Once, 200 ml/hr
		Give both 4gm and 2gm to get 6gm (Womens Hospital Only)(NOTE)*
	magnesium sulfate 4gm in 100mL water (WH/FH)
		4 gm, IVPB, Once, 300 ml/hr
			Comment: Give both a 4 gm and 2gm to get 6gm dose, infuse both bags in 30 minutes
	magnesium sulfate 2gm in 50mL water
		2 gm, Injection-Premix, IVPB, Once, 200 ml/hr
			Comment: Give both a 4 gm and 2gm to get 6gm dose, infuse both bags in 30 minutes
	magnesium sulfate 4gm in 100mL water
		4 gm, IVPB, Once, 200 ml/hr
			Comment: infuse over 30 minutes
		Mag Sulfate Maintenance IV(NOTE)*
	magnesium sulfate 20 gm in 500 mL water Premix IV
		500 mL, IV
			Comment: Discontinue IV if serum magnesium level greater than 81 gm/hr = 25 mL/hr1.5 gm/hr = 37.5 mL/hr2 gm/hr = 50 mL/hr2.5 gm/hr = 62.5 mL/hr3 gm/hr = 75 mL/hr
		20 gm, EVERY BAG, 2 gm/hr
Medications
	terbutaline
		0.25 mg, Injection, SUBCUTANEOUS, Q20MIN, STAT, 3 Dose(s)/Time(s)
			Comment: If maternal heart rate <120 and patient continues to contract.
		0.125 mg, Injection, SUBCUTANEOUS, Q20MIN, STAT, 3 Dose(s)/Time(s)
			Comment: If maternal heart rate <120 and patient continues to contract.
	NIFEdipine
		20 mg, Capsule, By Mouth, Q6H, NOW
		10 mg, Capsule, By Mouth, Q6H, NOW
	betamethasone
		12 mg, Injection, IM-IntraMUSCULAR, Q24H, Routine, 2 Dose(s)/Time(s)
		Consider these therapies if patient less than 32 weeks gestation(NOTE)*
	Indocin
		50 mg, Capsule, By Mouth, Once, NOW
			Comment: Give if less than 32 weeks gestation
		100 mg, Capsule, By Mouth, Once, NOW
			Comment: Give if less than 32 weeks gestation
		25 mg, Capsule, By Mouth, Q6H, 72 hr
			Comment: If bolus dose ordered, reschedule first dose for 6 hours later.  Give if less than 32 weeks gestation.
	ibuprofen
		400 mg, Tab, By Mouth, Q6H, NOW, 72 hr
			Comment: Give if less than 32 weeks gestation
	ketorolac injectable
		30 mg, Injection, IV PUSH, Once
			Comment: Give if less than 32 weeks gestation
		15 mg, Injection, IV PUSH, Once
			Comment: Give if less than 32 weeks gestation
	calcium gluconate
		1 gm, Solution, IV Push, Q5MIN, PRN, absence of deep tendon reflexes
Patient Care
	Notify MD
		T;N, If O2 sat less than 95%
		T;N, If Serum magnesium level greater than 8
		T;N, If respiration less than 12
		T;N, If DTRs absent
	Discontinue IV
		T;N, If serum magnesium greater than 8mg/dL, Once

*Report Legend:
DEF - This order sentence is the default for the selected order
GOAL - This component is a goal
IND - This component is an indicator
INT - This component is an intervention
IVS - This component is an IV Set
NOTE - This component is a note
Rx - This component is a prescription
SUB - This component is a sub phase