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NRSG 102: Med Surg 1 > Exam 1: Magnesium Imbalances > Flashcards

Exam 1: Magnesium Imbalances Flashcards

1
Q

What does Magnesium do?

A

Acts as an activator for many intracellular enzyme systems and plays a role in both carbohydrate and protein metabolism.

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2
Q

Normal Magnesium level?

A

1.3-2.3 mg/dL

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3
Q

Where does Magnesium go?

A

1/3 bound to protein, and 2/3 exist as free cations.

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4
Q

What happens with variations of Magnesium?

A

It affects neuromuscular irritability and contractility

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5
Q

What happens with excess magnesium?

A

It diminishes the excitability of the muscle cells

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6
Q

What happens with deficit of magnesium

A

Deficit increases neuromuscular irritability and contractility.

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7
Q

Magnesiums affect on cardiovascular system?

A

They act peripherally to produce vasodilation and decreased peripheral resistance.

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8
Q

Hypomagnesemia Range?

A

<1.8 mg/dL

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9
Q

Hypermagnesemia Range?

A

> 3.0 mg/dL

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10
Q

Hypomagnesemia Contributing Factors

A

Chronic Alcholism, Hyperparathyroidism, Diabetic Ketoacidosis, Refeeding after Starvation, Chronic Laxative Use , Heart Failure

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11
Q

Hypomagnesemia Signs/Symptoms

A

Neuromuscular Irritability, Positive Chvostek and Trousseau Sign, Mood Changes, Anorexia, Vomiting, Increased BP

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12
Q

Hypermagnesemia Contributing Factors

A

Oliguric Phase of Acute Kidney Injury

Adrenal Insufficiency, Excessive IV Magnesium, Hypothyroidism

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13
Q

Hypermagnesemia Signs/Symptoms

A

Fluishing, Hypotension, Muscle Weakness, Drowsiness, Hypoactive Reflexes, Depressed Respirations, Cardiac Arrest

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14
Q

What is Hypomagnesemia commonly associated with?

A

Hypokalemia and Hypocalcemia . They must all be address concurrently

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15
Q

What similarity does Hypomagnesemia share with Calcium

A
  1. It is the ionized frction of magnesium tha tis primarily involved in neuromuscular activity and other physiologic process
  2. Magnesium levels should be evaluated in combination with albumin levels
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16
Q

Hypomagnesemia Route?

A

Magnesium loss occurs in the GI Tract. This includes nasogastric sunction, diarrhea, or fistulas

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17
Q

Hypomagnesemia: Where is the major site of magnesium absorption?

A

the distal small bowel. Any disruption can lead to hypomagnesemia.

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18
Q

How may Hypomagnesemia occur?

A

With withdrawal from alcohol and administrationof tube feedings or parenteral nutrition

19
Q

Hypomagnesemia: Some clinical manifestations of Hypomagnesemia are due

A

directly to the low serum magnesium level; others are due to secondary changes in potassium and calcium metabolism

20
Q

Hypomagnesemia: Chvostek and Trousseau signs occur

A

in part, because of accompanying hypocalcemia

21
Q

Hypomagnesemia: Urine Magnesium May help

A

identify the cause of magnesium depletion and levels are measured after a loading dose of magnesium sulfate is given

22
Q

Hypomagnesemia: Medical Management: Diet

A

Mild Magnesium deficiency cna be corrected by diet alone.

23
Q

Sources of magnesium?

A

Green leafy vegetables, nuts, seeds, legums, whole grains, seafood, peanut butter, and cocoa

24
Q

Hypomagnesemia: Vital Signs must be assessed frequently during magnesium administration to

A

detect changes in cardiac rate or rhythm, hypotension, and respiratory distress.

25
Q

What is Hypermagnesemia?

A

It’s a rare electrolyte abnormality because the kidneys efficiently excrete magnesium.

26
Q

Hypermagnesemia: Most common type of how this occurs?

A

This is kidney injury. Another common type is lithium intoxication and extensive soft tissue injury or necrosis

27
Q

Hypermagnesemia: Acute elevation of magnesium causes

A

a depression of the central nervous system as well as the peripheral neuromuscular junction

28
Q

What can occur when Hypermagnesemia is very elevated?

A

Coma, Aatrioventricular Heart Block, and Cardiac Arrest

29
Q

Hypermagnesemia: What else is present when this is elevated?

A

Elevated levels of potassium and calcium as well

30
Q

Hypermagnesemia: Medical Management

A

This can be prevent by avoiding the administration of magnesium to patients with kidney injury

31
Q

Another major cause of symptomatic hypomanesemia in the United States is

A

chronic alcohol abuse

32
Q

Serum magnesium should be measured when for people going through alcohol withdrawal

A

2-3 days

33
Q

Hypomagnesemia symptoms do not occur until level has dropped below

A

1.8

34
Q

Hypomagnesium may be accompanied by marked alterations in psychological status such as

A

Apathy , depressed mood, apprehension, and extreme agitation

Dizziness
Insomnia and Confusion

35
Q

What must be addressed in addition to low serum magnesium levels?

A

Concurrent hypokalemia and hypocalcemia. These are difficult to correct until magnesium has been repleted

36
Q

Hypomagnesium: If necessary, magnesium salts can be given

A

orally in an oxide or gluconate form to replace continuous losses but may produce diarrhea

37
Q

Hypomagnesium: A bolus dose of mangesium sulfate given too rapidly can produce alterations in

A

cardiac conduction leading to heart block or astyole

38
Q

Hypomagnesium: Monitoring what is essential before, during, and after administration of magnesium?

A

Urine output. Physician notified if urine volume decreases to less than 100 mL over 4 hours.

39
Q

Hypermagnesium: What happens when serum magnesium levels exceed 10 mEq/L?

A

Respiratory center is depressed. Coma, atrioventricular heart block, and cardiac arrest can occur as well.

40
Q

Hypermagnesium: Administration of what enhances magnesium excretion?

A

Loop diuretics andSodium Chloride or LActated Ringer Solution

41
Q

Hypermagnesium: What does IV Calcium Gluconate do?

A

Anatagonizes the cardiovascular and neuromuscular effects of magnesium

42
Q

Hypermagnesium: If present, nurse monitors the

A

vital signs, noting hypotension and shallow respiration .

Allow decreased deep tendon reflexes and changes in consciousness.

43
Q

Magnesium produces its sedative effect at the neuromuscular junction probably by

A

inhibiting the releases of the neutrotransmitter acetycholine. Also increases the stimulus threshold in nerve fibers

44
Q

Magnesium acts directly on the

A

myoneural junction. Important for neuromuscular function

NRSG 102: Med Surg 1 (52 decks)

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