Magnesium general info
- Acts directly on myoneural junction
- Coenzyme in protein & carbohydrate metabolism
- Important for cardiac function
- 50-60% contained in bone
- Factors regulating Ca2+ balance appear to influence Mg2+ balance
- Normal 1.4-2.5mEq/L
What is the most common pathology associated with hypermagnesemia?
Increased intake/ingestion of products containing Mg2+ coupled with renal insufficiency/failure because kidneys are the primary mode of magnesium elimination.
What are the SnSs of hypermagnesemia?
- Muscle weakness, loss of deep tendon reflexes, seizure
- Depressed respirations-->apnea
- Bradycardia w/peaked T waves
- Hypotension (secondary to depressed contractility of vasculature)
Nursing intervensions for pt w/hyperMg2+
- Avoid meds & foods w/Mg2+
- Frequent Assessment neuro, respiratory, renal, cardiac
- If normal renal fxn then diuretics or IV NS to induce Mg2+ loss via urine.
- May need Ca2+ gluconate to minimize sx because it will have an exact opposite physiological effect on on muscle tissue.
- May need dialysis if v renal fnxn.
What are some common pathologies of hypoMg2+
- Chronic alcoholism due to the alcoholic's tendency toward insuffient food intake.
- Prolonged fasting/starvation
- Fluid loss, ie diuretics
- Prolonged parenteral nutrition w/o supplement
- Osmotic diuresis from high glucose due to uncontroled DM.
SnSs of hypoMg2+
- Tremors, muscle weakness, confusion, coma
- Hyperirritability, facial twitching, seizure
- Similar to hypocalcemia
- Cardiac irritability – dysrhythmia w/increased susceptibility to dig toxicity
Nursing intervensions for hypoMg2+
- Oral Mg2+ supplements
- Increase dietary intake of Mg2+
- If severe – IV or IM Mg2+