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annie morel

Magnesium

QuestionAnswer
Is magnesium an intracellular or intracellular cation? intracellular
What is the role of magnesium? it is responsible for carb metabolism and protein synthesis, neurromuscular excitability and calcium absorption through its effect on PTH
Magnesium affects the release of.... at neuromuscular junctions? acetylcholine
Does Mg trigger the sodium-potassium pump? yes
Mg is needed for what into the cell? for mvmnt of k into the cell
Mg can be toxic to the ...? heart
what kind of relationship do Mg and Phosphate have? inverse
What is the distribution of Mg in the bone? 50-60%
What is the distribution of Mg in the ECF? 1%
What is the distribution of Mg inside the cell? 40%
What is the normal limit of Mg? between 1.5-2.5
How much preotein is mostlybound to albumin? 30%
How much dietary Mg is absorbed in the intestine? 30-40%
Renal excretion of Mg is inhibited by..? FVD, reduced excretion of Na or Ca, and ^PTH
What happens to the heart rhythm in hypomagnesemia? V-tach--put on Mg, Ca, and Vit D supp.
what %of HypoMg occurs in hospitalized pt's? up to 12%
What %of ICU pt's have hypoMg? as high as 65%
What role does the kidney play in hypoMg? lowers Mg excretion to very low levels stimulated by a fall in the plasma Mg concentration
What plays important roles in ICU patients? nutrition, diuretics, hypoalbuminemia, and aminoglycosides
What are the levels of hypoMg? less than 1.5
What causes hypoMg? urinary loss, reduced GI absorption, and a shift of Mg into the ICF--(gastrointestinal or renal losses)
Regarless of cause hypoMg occurs after a relatively small Mg deficit b/c there is little rpid exchange of extracellular Mg with much larger bone and cell stores.
What are 5 factors that contribute to decreased Mg levels? loss of GI fluids or decreased intestinal absorptionprolonged malnutritionrenal disordersdrug therapy ^urinary losses such as aminoglycosides and loopsendocrine disordres altering secretion of ADH, aldosterone or Ca
What are some clinical settings where you may find hypoMg? acute or chronic diarrhea, malabsorption and steatorreha, small bowel bypass surgery, acute pancreatitis, spaonification of Mg amd Ca in necrotic fat, and worsened by the lowering of parathyroid hormone secretion and induces end-organ resistance to effect
What is the patho of hypoMg? occurs in combo with Ca and K deficitsall producing related neurologic and CV symptomstetany-like muscle contractions present esp. when hypoMg occurs in conjunction with hypoMg
What are the symptoms of hypoMg? usually not evident until lab value falls below 1.0
What are the characteristic manifestations of hypoMg? Weakness and tremors (tetany)
What are the CV manifestations of hypoMg? Tach and vent. dysrhythmias,ECG widening QRS complex and flattened or inverted T waves and prolongation of the PR interval, Mg and Ca and K deficiencies, low Mg levels ^the action of digitalis (potentiates)
How is hypoMg treated? with Ca and K supplements, IV Mg replacement if severeand continuous cardiac monitoring
what are some nursing assessments for hypoMg? at least 100 ml of urine/hr, assess for hyperMg, hypotension, flushing, sweating, depressed reflexes, (knee jerk), amd respiratory depression, sinificant depression of deep tendon reflexes signals hyperMg and is precursor to resp. dep. and cardiac arrest
What must be available in case of sudden hyperMg and hypocalcemic tetany? calcium gluconate
What else should the nurse assess the pt with hypoMg? health history,high risk factors like alcoholism, protein-calorie malnutrition, meds that promote urine excretion of Mg and GI losses
What are some S/S of hypoMg? lethargy, weakness, fatigue, insomnia, mood changes, confusion, anorexia, parathesias, tremors, chest pain, and dysphagia
With the physical exam what should you look for? tremors, twitching, tetany,positive for Chvostek's and Trouseau's signs, hyperactive deep tendon reflexesconvulsions, tach, HTN, anginaECG changes-atrial fib, heart block, PVC'shypoMg irritates the Heart!!!!
What is the nursing care for hypoMg? Administer Mg as prescribedmonitor renal functionsIV Mg sulfate must be adm. slowly and on an infusion pumpmonitor for diarrhea--common side effect!!diet high in Mg-green leafy veg, meats, nuts, bran, legumes, and fruitsmonitor for dig tox
What are more nursing care actions for hypomg? seizure precautions for severe hypoMgassess gag reflex and swallowing capability
What is hyperMg? It is Mg greater than 2.5
What happens with the kidneys with hyperMg? kidneys not efficient at eliminating excess
HyperMg results from renal...... insufficiency or failure
HyperMg caused by excess ingestion from antacids or ...? laxatives
HyperMg may occur after Mg sulfate administration to prevent seizures related to..? eclampsia
What needs to be assessed with hyperMg? health history, risk factors for--diminished renal function, chronic use of antacids, enemas and laxativesnausea, confusion drowsiness, muscular weaknessUse of accessory muscles for breathingshallow depressed respiratonsleading to resp.distres
What needs to be looked at during the physical examination for hyperMg? Mg level greater than 2.5
What does ths nurse need to assess for during the physical exam? peripheral vasodilation, hypotension-causing flushing, diminished DTR's, dyspnea, and diaphoresisheart problems, weak pulse, brady, heart block, cardiac arrest, ECG changes-prolonged PR interval, widened QRS complex and tall T wave
what are some nursing interventions for hyperMg? Teach pt to avoid foods rich in Mg and meds that contain Mg(Riopan, Mylanta, and Maalox)teach pt to read drug labels and review all over the counter meds with dr.caution pts with renal compromise about the hazards of excess use of laxatives&enemas
What are some other nursing interventions for hyperMg? review signs and symptoms that need to be reported to the dr.
What risk factors should you assess for with hyperMg? Elderly, renal disease, pregnant women treated with Mg sulfate, dehydration, DKA, hypothyroidisn, high Mg intake, assess VS closely-hypotension, resp. distress (report immediately)REPORT SLL SYMPTOMS OF HYPERMG!!!!
Created by: anniemorel