Magnesium & Calcium Flashcards
Magnesium and Calcium act like what ?
Sedatives
What is Magnesium excreted by ?
The kidneys
(but it can also be lost in other ways such as the GI tract
What are causes of Hypermagnesemia ?
- Renal failure
- Antacids (if kidneys are okay, then they are okay to take)
HINT
If you want to get Magnesium and Calcium questions right, what should you think of first ?
Think Muscles 1st
What are signs and symptoms of Hypermagnesemia ?
- Flushing and Warmth
- Mg causes vasodilation
What is the Treatment for Hypermagnesemia ?
- Ventilator
- Dialysis
- Calcium gluconate (Antidote for Mg toxicity)
- Safety precautions
What is Calcium gluconate ?
The Antidote for Magnesium toxicity
How should Calcium Gluconate be administered ?
Should be administered IVP very slowly
Max rate: 1.5 -2mL/min
What are signs and symptoms that are common in clients with Hypermagnesemia or Hypercalcemia ?
- Decreased deep tendon reflexes
- Weak or flaccid muscle tone
- Arrhythmias
- Decreased LOC (d/t sedation)
- Decreased pulse
- Decreased respirations (d/t sedative effect)
If respirations fall below 12 = needs ventilator
What are causes of Hypercalcemia ?
- Hyperparathyroidism (Too much PTH)
when your serum gets low, PTH kicks in and pulls Ca from the bone and puts it in the blood: therefore the serum Ca goes up - Thiazides (retain Ca)
- Immobilization (you have to bear weight to keep Ca in the bone)
What are signs and symptoms of Hypercalcemia ?
- Brittle bones
- Kidney stones (*majority are made of calcium)
What is the Treatment for Hypercalcemia ?
- Move! (weight bearing)
- Fluids (prevent kidney stones)
- Add Phosphorus to the diet (Proteins contain phosphorus)
–> B/c Ca & Phosphorus have an inverse relationship - Steroids
- Safety precautions (b/c of sedation)
- Medications that decrease serum Calcium
(Ex: Bisphosphates, Calcitonin)
Calcium and Phosphorus have what ?
An inverse relationship
What should you think of with Hypomagnesemia and Hypocalcemia ?
Not enough Sedative
What are causes of Hypomagesemia ?
- Diarrhea (lots of Mg in the intestines)
- Alcoholism*
- Alcohol suppresses the release of ADH & its hypertonic which makes you diurese
Where do we get the majority of our Magnesium ?
From our diet
What are signs and symptoms of Hypomagnesemia or Hypocalcemia ?
- Muscle tone = rigid/tight
- Possible seizures
- Stridor/laryngospasm (airway is a smooth muscle)
- Chvostek’s (tap cheek) (“C” is for cheek)
- Cheek will twitch if tapped
- Chvostek’s (tap cheek) (“C” is for cheek)
- Trousseau’s (pump up BP cuff - hand will drawn down or tremor)
- Arrhythmias (heart is a muscle)
- Increased DTR’s
- Mind changes (unpredictable)
- Swallowing problems (#1 problem, risk for aspiration) (esophagus is a smooth muscle)
What is the Treatment for Hypomagnesemia ?
- Give some MG
- Check kidney function (before and during IV Mg)
- Seizure precautions
- Eat magnesium
- Stop the infusion if the client reports flushing and sweating when you start the IV Magnesium (Assume the worst)
What are foods high in Magnesium ?
- Spinach - Peppermint
- Mustard greens - Cucumber
- Summer squash - Green beans
- Broccoli - Celery
- Halibut - Kale
- Turnip greens - Sunflower seeds
- Pumpkin seeds - Sesame seeds
- Flax seeds
What are causes of Hypocalcemia ?
- Hypoparathyroidism
- Radical neck
- Thyroidectomy
- All these = Not enough PTH
- Serum calcium = decreased
What is the Treatment for Hypocalcemia ?
- PO calcium
- IV calcium (GIVE SLOWLY) and always make sure the client is on a heart monitor
- Vitamin D
- Phosphate binders (b/c of inverse relationship with calcium)
Why do you want client’s receiving IV calcium to be on a heart monitor ?
B/c it will widen the QRS complex
- A little is okay, but not a lot or there is a potential for Asystole
