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A patient was admitted for preterm labor, screened by RN #1 and examined by a physician. The physician gave RN #2 a verbal order for 4 gm bolus/2 gm maintenance MgSO4. RN #2 placed a large bag of MgSO4 on the IV pole and programmed the IV pump; she started the MgSO4 bolus and then was called away. Later the IV pump alarm went off and RN #1 started a second bolus. The patient complained of feeling sick but this was not addressed; the FHT alarm also was not addressed, which occurred around the time of change of shift. The physician was concerned about his order being lost during the change of shift, so he repeated the order to oncoming RN #3 but did not tell her that it was a repeat order. RN #3 gave a third bolus. Shortly after, the RNs realized that the patient had received three separate doses of 4 Gm MgSO4. All three nurses and the physician immediately went to check on the patient, and the physician ordered a stop to the MgSO4 and obtained a magnesium level. On receiving a report describing these facts, th

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  • A patient was admitted for preterm labor, screened by RN #1 and examined by a physician. The physician gave RN #2 a verbal order for 4 gm bolus/2 gm maintenance MgSO4. RN #2 placed a large bag of MgSO4 on the IV pole and programmed the IV pump; she started the MgSO4 bolus and then was called away. Later the IV pump alarm went off and RN #1 started a second bolus. The patient complained of feeling sick but this was not addressed; the FHT alarm also was not addressed, which occurred around the time of change of shift. The physician was concerned about his order being lost during the change of shift, so he repeated the order to oncoming RN #3 but did not tell her that it was a repeat order. RN #3 gave a third bolus. Shortly after, the RNs realized that the patient had received three separate doses of 4 Gm MgSO4. All three nurses and the physician immediately went to check on the patient, and the physician ordered a stop to the MgSO4 and obtained a magnesium level. On receiving a report describing these facts, th


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