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Magnesium and Calcium Flashcards

1
Q

Where is magnesium excreted?

A

Kidneys (but can also be lost in other ways)

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2
Q

What are the normal Mg levels?

A

1.3-2.1

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3
Q

What are the normal calcium levels?

A

9-10.5

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4
Q

Hypermagnesium and hypercalcemia think _____

A

SEDATION

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5
Q

Hypermagnesemia

Causes?

A

Renal failure (since most is excreted by kidneys, if RF then kidneys aren’t excreting it well and it builds up)

Antacids

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6
Q

Hypermagnesemia

S/S ?

A

Flushing

Warmth

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7
Q

Hypermagnesemia

Magnesium makes you ____

A

Vasodilate

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8
Q

Hypermagnesemia

Treatment?

A

Ventilator
Dialysis
Calcium gluconate
Safety precautions

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9
Q

What is the antidote for MAG toxicity??

A

Calcium gluconate

*give IVP SLOWLY !!!

Max rate: 1.5-2 mL/min

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10
Q

Calcium and ____ have an inverse relationship

A

Phosphorous

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11
Q

Hypercalcemia

Causes?

A
  • Hyperparathyroidism
  • Thiazides
  • Immobilization
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12
Q

Hypercalcemia

Why does having too much PTH cause hypercalcemia?

A

When serum Ca gets low, PTH pulls Ca from the bone and puts it in blood. So if too much PTH, then it pulls to much Ca from bone to blood

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13
Q

Hypercalcemia

What do thiazides do?

A

Retain Ca

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14
Q

Hypercalcemia

You have to do what to keep Ca in bone?

A

Bear weights!! Thats why immobilization is a cause!

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15
Q

Hypercalcemia

S/s?

A

Bones are brittle

Kidney stones

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16
Q

Hypercalcemia

Tx?

A
  • Move
  • Fluids
  • Add phosphorous to diet
  • Steroids
  • Safety
  • Vit. D
  • Meds
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17
Q

Hypercalcemia

Why fluids for tx?

A

To help prevent kidney stones

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18
Q

Hypercalcemia

Ca has inverse relationship with phosphorous. We need to add phosphorous to diet to help bring down Ca. What has phosphorous?

A

Foods with protein

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19
Q

Hypercalcemia

Why take steroids?

A

Steroids bring down serum Ca

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20
Q

Hypercalcemia

Must have Vit. D to use Ca. What else is good?

21
Q

Hypercalcemia

What are meds that decrease serum Ca?

A
  • Bophosphates (dronates)
  • Prostaglandin synthesis inhibitors
  • Calcitonin
22
Q

Hypercalcemia

What does Calcitonin do?

A

Decreases serum Ca by driving it back to the bone

23
Q

What are S/s common in BOTH hypermagnesemia and hypercalcemia?

  • DTR?
  • Muscle tone?
  • Heart?
  • LOC?
  • RR?
A 
DTR: Decrease
Muscle tone: Weak, flaccid
Heart: Arrhythmias, decrease HR
LOC: Decrease
RR: Decrease

Remember: Think SEDATIVE!!!

24
Q

Hypomagnesemia

What are some causes?

A

Diarrhea (remember Mg can be excreted through GI tract too–diarrhea makes you loose too much)

Alcoholism

25
Q

Hypomagnesemia

Treatment? (4)

A
  1. Give Mg
  2. Check kidney function (before and during IV Mg)
  3. Seizure precautions
  4. Eat Mg
26
Q

Hypomagnesemia

What do you do if your client reports flushing and sweating when you start IV mg?

A

STOP INFUSION!!!

While these are normal signs, it can lead to things that are worse!!!

27
Q

Hypocalcemia

Causes?

A

HypoPTH
Radical neck
Thyroidectomy

*all these= not enough PTH. PTH normally pulls serum Ca from bone when serum Ca levels are low. If not enough PTH, then not enough Ca in blood

28
Q

Hypocalcemia

Tx?

A
  • Vit. D (to help utilize Ca)
  • Phosphate binders
  • IV Ca (give slowly!!!–monitor heart)
29
Q

Ex. of phosphate binders?

A

Sevelamer hydrochloride

Calcium acetate

30
Q

S/s of both HYPOMg and HYPOCa

Muscle tone?
Seizure?
Airway?
Signs?
Heart?
DTR?
Brain?
A
  • Muscle tone: Rigid, tight
  • Yes, risk for seizure
  • Stridor/laryngospasm/swallowing problems
  • Chvostek and Trousseau sign= +
  • Arrhythmias
  • Increase DTR
  • Mind changes—like psychotic, depressed, etc
31
Q

Hyper and hypo Mg, and hyper and hypo Ca can cause arrhythmias..Which one can cause a widened QRS?

A

HYPOcalcemia!

32
Q

HyperMg and HyperCa think ____

33
Q

HypoMg and HypoCa think ____

A

NOT ENOUGH SEDATION

34
Q

With Mg and Ca questions, think ___ first

35
Q

HyperMg/Ca or HypoMg/Ca

Arrhythmias

36
Q

HyperMg/Ca or HypoMg/Ca

Increased DTR

37
Q

HyperMg/Ca or HypoMg/Ca

+ Trousseau sign

A

Hypo

*this is when you pump BP cuff and hand tremors

38
Q

HyperMg/Ca or HypoMg/Ca

Seizure risk

39
Q

HyperMg/Ca or HypoMg/Ca

Psychotic, depressed type mind changes

40
Q

HyperMg/Ca or HypoMg/Ca

Decreased HR

41
Q

HyperMg/Ca or HypoMg/Ca

Stridor/laryngospasm

42
Q

HyperMg/Ca or HypoMg/Ca

Decreased RR

43
Q

HyperMg/Ca or HypoMg/Ca

Rigid, tight muscles

44
Q

HyperMg/Ca or HypoMg/Ca

Decreased DTR

45
Q

HyperMg/Ca or HypoMg/Ca

Swallowing problems

46
Q

HyperMg/Ca or HypoMg/Ca

Muscle tone weak and flaccid

47
Q

HyperMg/Ca or HypoMg/Ca

+ Chvostek sign

A

Hypo

This is when you tap cheek and the cheek twitches

48
Q

HyperMg/Ca or HypoMg/Ca

Decreased LOC

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