hello students good morning I'm miss Henderson  today I am going to be talking to you I'm gonna  

be presenting to you some calculations  of obstetric calculations on pitocin and  

magnesium sulfate flow rates so let's look at  some of our morning objective for this lesson  

so upon completion of this lecture student will  be able to demonstrate the following competency  

ability to safely calculate magnesium sulfate  bolus demonstrate competence in calculating flow  

rates according to doctor's order demonstrate  the ability to calculate the Tosun flow  

rates discuss the indication for pitocin and  verbalized indications for magnesium sulfate so

so the first problem we have here on the board  calculating magnesium sulfate flow rate so the  

physician has ordered magnesium sulfate bolus  with 4 grams in a hundred milliliters of lactated  

ringers solution to be given over 20 minutes what  rate should the nurse set the infusion pump so as  

you can see I have set up the equation we're  looking for xml's per hour so we were giving  

the volume we were giving a hundred milliliters  in four grams and that is to be infused in 20  

minutes so we have a hundred milliliters and  we have our time twenty minutes and we know we  

in flow rate we're looking for milliliters per  hour so we know one in every hour is equal to  

sixty minutes so we are ready to solve this  problem so we have minutes cancelling out

and we know that 2020 goes into 63 times right  we know 20 goes into 63 times so we have three  

so then we have three times a hundred is equal to  three hundred so we have three hundred milliliters  

per hour that's what the nurse is going to program  the IV pump to administered so let's look at some  

of the indications for magnesium sulfate what are  some of the indications for magnesium sulfate sold  

some of the indications for magnesium sulfate  is that it lowers the blood pressure it's used  

to treat preeclampsia a clumsier and it also  helped helps to prevent seizure disorder so we  

also have some contraindications for magnesium so  these are the contraindications so patients that  

have impaired renal function it's contraindicated  to use magnesium salt sulfate patients with heart  

black or myocardial damage it's contraindicated  also patients with myasthenia gravis cannot use  

magnesium sulfate magnesium sulfate also interacts  with nipi nevirapine so it's also contraindicated

so let's look at pitocin so what are some of the  indications of of pitocin so we know pitocin is  

a hormone right oxytocin and it's really by  the posterior pituitary gland so oxytocin is  

used in obstetric it helps to increase uterine  contraction it facilitates cervical dilatation  

it helps to facilitate vaginal delivery  it increased bonding within the mom and  

the fetus it stimulates milk ejection for  breast feeding it also reduces stress that  

may contribute to postpartum depression so those  are some indications for oxytocin so let's look  

at another problem here so we have here magnesium  flow rate magazine magnesium sulfate 40 gram in a  

thousand milliliter of lactated ringers at a rate  of 2 grams per hour what is the pump rate so what  

would the nurse set the pump so we are looking  again for flow rate which is milliliters per  

hour so using dimensional analysis we are going  to set up the equation so XML per hour equal to  

we were giving a thousand ml of lactated ringers  that sort of volume and with a thousand MLS per  

hour and we also within that thousand we have 40  grams so we have 40 grams here right and then the  

ringer at a rate of 2 grams per hour so we have  every 2 grams in 1 hour so now we have grams

cancelling out with grams we have to

goes into 40

we have Z we have we can cancel zero  here we can cancel another zero here

and we left with two goes into 4 into 4  2 times we have 2 here and 2 goes into a  

hundred how many times 50 times so we have 50  milliliters per hour that's what the nurse is  

going to program the IV pump to deliver so let's  look at a another problem so pitocin flow rate  

calculation the physician has ordered 2 million  units per minute pitocin is available with 10  

units per ml protocol on the L&D unit mix two  vials per a thousand ml of normal saline what  

should the nurse set the IV pump at so we  know in every in one unit it's equal to a  

thousand million 'its we also know 60 minutes  is equal one error because that was given to us  

in the problem so now we have we're looking for  what flow rates right so we have one unit is in

a thousand million units and we have  one hour is equal to sixty minutes and  

it was given to us a physician has  all a 2 milli units so we have two  

million units per minute times the the  volume the vial which is a thousand ml

and protocol states two vials of ten  units so if we have two vials of ten  

unit which is 20 units we have 20  units in a thousand of ml so now  

we are ready to solve the problem  we have million units canceling out

we have mints cancelling out  with minutes we have units

units canceling out with units so now we have  here sixty times two times a thousand divided  

by 1,000 or we can even cancel this out one  thousand into one thousand is one we have also  

twenty into sixty it's three and then we have 3  times 2 which is 6 that gives us six milliliters  

per hour and that's what the nurse is going to  program the pump to deliver so let's look at  

another problem guys so in this in this question  here the physician has ordered 500 milliliter of  

d5w with ten units of IV oxytocin begin at two  million units per minute and then increased by  

one milli units per every 30 minutes until  regular uterine contractions begin maximum  

dose is 30 million units per minute so the first  aspect of the problem is asking us what is the IV  

flow rate for the beginning infusion so let's  solve this so we're looking for milliliters  

per hour so using dimensional analysis we  can set up the equation to solve for x ml  

per hour so we were giving the fuzziness order  500 milliliters in 10 units so we know 500 goes  

with 10 units and we know one unit is equal to  1000 million --it we were also given beginning  

infusion at 2 milli units per a minute and  we know one hour is equal to 60 minutes so  

now we are ready to solve this equation so we  have minutes and minutes cancelling out we have  

many units and milli units canceling out we have  units and unit canceling out so we have here 500

times two times 60 or we can go ahead and  cancel 10 goes into 60 six times right we  

have 500 goes into a thousand how many times two  times so if you do the calculations you should  

have six milli six milliliters per hour which  is the beginning infusion rate now that other  

elements of the problem is asking what is the  IV flow rate for the maximum infusion so it's  

the same concept setting up the equation we have  our milliliters per 10 units and we were given  

the maximum dose is 30 milli units so we have  510 in 10 units one unit is a thousand million  

units and the max the maximum dose is stirred  30 milli units per minute and one hour is 60  

minutes so if you do the calculation the maximum  infusion rate should be 90 moly liters per hour so

so I wanted to really do this short scream o  matic - you know deepen your understanding of  

the obstetric calculation for mass for med and you  are 103 I hope you find this short presentation  

engaging and I hope it helps to enhance your  knowledge in obstetric calculation so I have  

some practice problems in the remainder of the  slides so you can have fun doing those and I also  

indicate the answers for most of them thank you so  much and see you in the next lecture bye for now

you