Magnesium

Magnesium

1. Hypermagnesemia

   • Signs & Symptoms
     • Depresses Neuromuscular & CNS function
     • Severe
       • Bradypnea & Bradycardia
       • Cardiac Arrest (Bradycardia/Hypotension)
       • Respiratory
     • later stage
       • DTR's lost
       • Solmenence
     • Intial
       • Lethargy
       • N&V
     • Diaphrosesis
     • Decreased LOC
   • Causes
     • Increased Magnesium + Renal Insufficiency
     • Excessive Intravenous Magnesium
     • Magnesium Sulfate (Eeclampsia)
   • Interventions
     • Chronic Kidney failure patients
       • Teach danger of Mg. Containing Antiacids
       • Dialysis
     • Normal Renal Function
       • Diuretics
         • Furosemide
     • Limit Ingestion of green veggies, nuts, bananas, oranges, peanut butter, Chocholate)
     • Sever Hypermagnesium
       • Calcium Gluconate
         • oppose effects of magnesium on Cardiac cells 
     • Monitor
       • Decreasing LOC
       • Report if the patient has absent DTR

2. Hypomagnesemia

   • Signs & Symptoms
     • Tetany
     • WATCH FOR: CONFUSION/ DEPRESSION & irritability, Nystagmus
     • Chvostek & Trousseau signs
     • Hyperactive DTR
     • Leg & Foot Cramping
     • CARDIAC dysrthmia
     • difficulty swallowing
   • Causes
     • Metabolic Acidosis
     • Malabsorption
       • inflammatory Bowel Disease
     • Malnutriton
     • Loop/thiazide diuretics
     • Muscle Excitability/ Tremors
     • Alcoholism
   • Interventions
     • Foods High in Magnesium
     • If magnesium Sever or Hypocalcemia Present administer IV magnesium (infusion pump)
       • Slowly (Prevent Cardiac & Respiratory Arrest) (<150mg/min)
       • NEVER as IV bolus (cardiac arrest)
       • check for decreased patellar reflexes, Respiratory difficulty & decreased Blood pressure! if these occur STOP!
     • Teach Magnesium Rich FOODs
     • ASSESS k+ & Ca+
       • Hypocalcemia &amp; Hypokalemia
     • Diuretics may be d/c
     • assess presence of dysphagia

3. 1.5-2.5mEq/L

4. Normal Lab value does not mean appropriate Mg Levels are in the ICF. Highly interrelated with K+ & Ca+

5. Look at Ca+, Mg+ & K+ Together