Magnesium Imbalances

Question 1

Magnesium function

Answer 1

Electrolyte that helps stabilize cardiac and smooth muscle cells

Question 2

Word for elevated serum magnesium

Answer 2

Hypermagnesemia

Question 3

Word for low serum magnesium

Answer 3

Hypomagnesemia

Question 4

Hypermagnesemia causes

Answer 4

1. Renal failure with increased magnesium intake (most common)
2. Too much IV magnesium (sometimes given to pregnant women)

Question 5

Most common cause of hypermagnesemia

Answer 5

Renal failure + increased magnesium intake (i.e., CKD patient taking Maalox)

Question 6

Hypomagnesemia causes

Answer 6

GI tract fluid losses (i.e., nausea/vomiting, diarrhea, NG suction)
Malnourishment (low intake, prolonged malnutrition, chronic alcohol use)

Question 7

How chronic alcohol use can cause hypomagnesemia

Answer 7

Chronic alcohol use -> inadequate nutritional intake/malnourishment -> low magnesium

Question 8

Hypermagnesemia manifestations

Answer 8

Think nerves and muscles SLOWING DOWN

Question 9

Hypermagnesemia manifestations

Answer 9

Lethargy, drowsiness, muscle weakness, decreased deep tendon reflexes (DTRs)–think nerves and muscles slowing down

Question 10

Hypermagnesemia nursing care-what to do if magnesium high

Answer 10

Avoid magnesium-containing drugs and foods high in magnesium
Force fluids (FF) to promote urinary excretions IF kidneys are healthy
Dialysis for CKD patients
IV calcium gluconate IF SYMPTOMATIC (IV calcium gluconate opposes effects of excess Mg on cardiac muscle)

Question 11

Examples of magnesium-containing drugs

Answer 11

Maalox, Mylanta

Question 12

Examples of foods high in magnesium

Answer 12

Green vegetables, nuts, bananas, oranges, peanut butter, chocolate

Question 13

Should you force fluids in CKD patients to promote urination to remove excess magnesium

Answer 13

No-only force fluids if kidneys are ok

Question 14

When do you give IV calcium gluconate for hypermagnesemia

Answer 14

When the patient is symptomatic

Question 15

What are two different electrolyte imbalances that both cause nerves and muscles to rev up

Answer 15

Hypomagnesemia and hypocalcemia

Question 16

Hypomagnesemia manifestations

Answer 16

Revved up nerves and muscles:
Confusion
Muscle cramps
Tremors
Seizure
Vertigo (dizziness)
Hyperactive DTRs
Positive Chvostek's/Trousseau's signs
Increased pulse and BP
Cardiac dysrhythmias

Question 17

Hypomagnesemia nursing care (treat cause/symptoms)

Answer 17

ORAL Mg replacement (with Mylanta or magnesium sulfate)

IV magnesium sulfate

Question 18

Should IV magnesium sulfate be given quickly or slowly

Answer 18

Must replace Mg SLOWLY over several days when using IV magnesium sulfate

Question 19

Can you IV push magnesium sulfate if necessary

Answer 19

Yes, but rapid infusion can cause severe hypotension

Question 20

What can rapid infusion/IV push of magnesium sulfate cause

Answer 20

Severe hypotension

Question 21

What should you closely monitor when giving magnesium sulfate IV push

Answer 21

Blood pressure (rapid infusion can cause severe hypotension)