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NCLEX - HURST REVIEW (Fluid & Electrolytes) > Magnesium & Calcium > Flashcards

Magnesium & Calcium Flashcards

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1
Q

Magnesium and Calcium act like what ?

A

Sedatives

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2
Q

What is Magnesium excreted by ?

A

The kidneys

(but it can also be lost in other ways such as the GI tract

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3
Q

What are causes of Hypermagnesemia ?

A
  • Renal failure

- Antacids (if kidneys are okay, then they are okay to take)

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4
Q

HINT

If you want to get Magnesium and Calcium questions right, what should you think of first ?

A

Think Muscles 1st

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5
Q

What are signs and symptoms of Hypermagnesemia ?

A
  • Flushing and Warmth

- Mg causes vasodilation

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6
Q

What is the Treatment for Hypermagnesemia ?

A
  • Ventilator
  • Dialysis
  • Calcium gluconate (Antidote for Mg toxicity)
  • Safety precautions
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7
Q

What is Calcium gluconate ?

A

The Antidote for Magnesium toxicity

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8
Q

How should Calcium Gluconate be administered ?

A

Should be administered IVP very slowly

Max rate: 1.5 -2mL/min

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9
Q

What are signs and symptoms that are common in clients with Hypermagnesemia or Hypercalcemia ?

A
  • 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
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10
Q

What are causes of Hypercalcemia ?

A
  • 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)
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11
Q

What are signs and symptoms of Hypercalcemia ?

A
  • Brittle bones

- Kidney stones (*majority are made of calcium)

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12
Q

What is the Treatment for Hypercalcemia ?

A
  • 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)
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13
Q

Calcium and Phosphorus have what ?

A

An inverse relationship

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14
Q

What should you think of with Hypomagnesemia and Hypocalcemia ?

A

Not enough Sedative

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15
Q

What are causes of Hypomagesemia ?

A
  • Diarrhea (lots of Mg in the intestines)
  • Alcoholism*
  • Alcohol suppresses the release of ADH & its hypertonic which makes you diurese
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16
Q

Where do we get the majority of our Magnesium ?

A

From our diet

17
Q

What are signs and symptoms of Hypomagnesemia or Hypocalcemia ?

A
  • 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
    • 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)
18
Q

What is the Treatment for Hypomagnesemia ?

A
  • 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)
19
Q

What are foods high in Magnesium ?

A
  • Spinach - Peppermint
  • Mustard greens - Cucumber
  • Summer squash - Green beans
  • Broccoli - Celery
  • Halibut - Kale
  • Turnip greens - Sunflower seeds
  • Pumpkin seeds - Sesame seeds
  • Flax seeds
20
Q

What are causes of Hypocalcemia ?

A
  • Hypoparathyroidism
  • Radical neck
  • Thyroidectomy
  • All these = Not enough PTH
    • Serum calcium = decreased
21
Q

What is the Treatment for Hypocalcemia ?

A
  • 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)
22
Q

Why do you want client’s receiving IV calcium to be on a heart monitor ?

A

B/c it will widen the QRS complex

  • A little is okay, but not a lot or there is a potential for Asystole

NCLEX - HURST REVIEW (Fluid & Electrolytes) (6 decks)

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