Hypomagnesemia

Question 1

Normal range of magnesium

Answer 1

1.8-2.6

Question 2

Function of magnesium

Answer 2

Regulation of Parathyroid hormones
Muscle and nerve function
Blood pressure regulation
Maintain normal intercellular level of potassium
Blood coagulation
Cardiac stability
Cell growth
Metabolism of carbohydrates, lipids and proteins

Question 3

Where magnesium absorbed in

Answer 3

Small intestine

Question 4

Which organ help in excretion of magnesium

Answer 4

Kidney

Question 5

Causes of hypo magnesium

Answer 5

LOW MAG
Limited intake of magnesium-starvation
Other electrolytes- hypokalemia and hypercalcemia
Wasting magnesium- loop and thiazide diuretics, cyclosporine
Malabsorption issues-Chron’s, celiac, proton pump inhibitors drugs
Alcohol intake
Glycemic issues- diabetic ketoacidosis, insulin administration

Sepsis

Question 6

How hypercalcemia caused hypomagnesemia

Answer 6

Hypercalcemia causes low absorption of magnesium in kidneys

Question 7

How hypomagnesemia causes hypokalemia

Answer 7

Directly hypokalemia does not cause hypomagnesemia
Magnesium plays role in regulating potassium reabsorption in kidney
Low magnesium cause increases potassium loss in urine

Question 8

How alcohol intake cause hypomagnesemia

Answer 8

Increased secretion of magnesium from kidneys

Question 9

Clinical manifestations of hypomagnesemia

Answer 9

Magnesium act like a sedative
Increased neuromuscular irritability
Increased deep tendon reflexes
Hyperreflexia
Shallow respiration
Twitches and paresthesias
Tetany and seizures
Irritability and confusion
Positive trousseau’s sign
Increased heart rate
Hypertension
Positive chvostek’s sign
ECG changes (QT prolongation and torsades de pointes)
Decreased bowel sound and mobility

Magnesium and calcium rise and fall together
High calcium intake can cause low magnesium levels if magnesium intake is low

Question 10

Interventions

Answer 10

Administer magnesium sulfate via PO if mild and IV if severe
During IV magnesium infusion, monitor for signs of magnesium toxicity
May administer potassium supplements due to hypokalemia
Place the patients in seizure precautions

Question 11

Signs of magnesium toxicity

Answer 11

Respiratory depression
Absent DTRs
Low urine output

Question 12

What is the antidote for magnesium toxicity

Answer 12

IV calcium gluconate