F&E (Exam 3) mag-cal-phos Flashcards
Magnesium
Hypomagnesemia <1.3
Hypermagnesemia > 2.1
Magnesium
-Helps to stabilize cardiac muscle cells
-Blocks/controls movement of K out of cardiac cells
-Helps stabilize smooth muscle (Muscle and Movement)
Hypomagnesemia: Causes
-Diuresis, Gi or renal losses, limited intake (fasting or starvation), alcohol abuse, pancreatitis, hyperglycemia
Hypomagnesemia: S/S
-Hyperactive reflexes, confusion, cramps, tremors, seizures
Hypomagnesemia: Treatment
-Replace orally or IV
Oral Magnesiamia replacement
-Mylanta
-Magnesium sulfate
IV magnesium sulfate
-Replace over several days
-Can be IV push if necessary
-Can push if necessary
Hypomagnesemia Cardnial Sign
Nystagmus
Magnesium Sulfate and Magnesium Oxide: MOA
Replacing Magnesium
IV or PO
MS or MO: Indication
Hypomag, prevent/treat seizures, treat cardiac rhythm
Mag Sulfate used to prevent preeclampsia and eclampsia
MS and MO: Adverse Effects
-Hypermag: Confusion, sluggish, slow movements, SOA, dizzy and abnormal heart thythem
-Can burn given IV
Hypermagnesemia: Causes
Increased intake and renal failure
Person who takes milk of magnesium for constipation and has renal failure
Hypermag: S/S
-Lethargy, floppiness, muscle weakness, decreased reflexes, flushed/warm skin, decreased pulse/BP
Hypermag: Treatment
-Stop replacement, if chronic disease (dialysis)
Calcium
Hypocalcemia <9.0
Hypercalcemia > 10.5
-Hormones released by the thyroid and parathyroid glands are controllers of the amount of calcium that is released from and absorbed into the bone
Majority of calcium is in the
The bone 99%
40% protein bound
10% chelated
50% ionized and ready for used
Calcium Responsible for
Enzyme reactions
Helps in release of hormones, neurotransmitters, and chemical mediators
Effects membrane potentials and nerve excitability
Influences cardiac contractility and automaticity
Necessary for blood clotting (part of clotting cascade)
Hypocalcemia: What causes it?
Unable to mobilize from bone
Hypoparathryoidsim
Hypomagnesemia
Decreased vitamin D
Thryoid and parathyroid surgery
Hypocalcemia: Increased neuromuscular excitability
-Parathesias (Numbness and Tingling)
-Muscle cramps
-Bone pain
-Tetany
-Laryngeal spasm
-Hyperactive relfexes
Hypocalcemia: Cardiac insufficiency
-Prolonged QT interval- can lead to fatal arrhythmia
Two distinct signs of hypocalcemia
-1. Chvostek’s sign: Ipsilateral twitching of the circumoral muscles in response to gentle tapping of the facial nerve just anterior to the ear
-2. Trousseau’s sing: Carpal spasm upon inflation of the BP cuff to 20 mmHg above the patients systolic blood pressure for three minutes
Hypocalcemia: Treatment IV
-IV calcium (Only given through central line Vesicant)
- Calcium Chloride - Give though central line
- Calcium Gluconate - Prefer to give though central line
Hypocalcemia: Oral Treatment
-Elemental calcium, calcium carbonate (Tums)
-May also need Vit D (Active form in impaired liver or kidney function)
Hypercalcemia: Causes
-Hyperparathyroidism, cancers
Hypercalcemia: S/S
-Calcium acts like a sedative, fatigue, lethargy, confusion, weakness, seizure and coma
-Kidney stones
Hypercalcemia: Treatment
-Adequate Hydration
-Increased urine output
-Diuretic and NaCl
-Dialysis in renal failure
Phosphorus
Hypophosphatemia <3.0
Hyperphosphatemia >4.5
Calcium and Phosphate
Inverse relationship
Low serum calcium = High phosphate
Phosphorus Found
Bone 85% and intracellular 14%
Inorganic Phosphorus
-Circulating and measured
Organic Phosphorus
Intracellular
Hypophosphatemia: Causes
-Decreased absorption
-Antacids overdose
-Diarrhea
-Increased kidney elimination
-Malnutrition (Alcoholism-TPN-Recovery)
Hypophosphatemia: Clincial Manifestionations severe
-Tremor
-Paresthesia
-Confusion
-Seizure
-Muscles weakness
-Joint stiffness
-Bone Pain
Hyperphosphatemia: Causes
-Kidney failure
-Laxatives/enemas
-Shift from intra to extracellular compartment
-Hypoparathyroidism
Hyperphosphatemia: Clinical manifestations
-Usually asymptomatic
-Typically only symptoms of hypocalcemia: Muscle spasms, paresthesia, tetany
Hypophosphatemia: Treatment
-IV or Oral replacement
-Increase oral intake
-take are with CKD or Hypercalcemia
Increased risk of calcifications
Hyperphosphatemia: Treatment
-Treat the cause