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*N126-U4-Magnesium*
Dobrisky-Magnesium
| Question | Answer |
|---|---|
| magnesium is a major intracellular | cation |
| magnesium is responsible for the metabolism of | carbohydrates and the synthesis of protein |
| which affects metabolism of carbs & synthesis of protein: calcium, sodium or magnesium? | magnesium affects the metabolism of carbs and the synthesis of protein |
| magnesium triggers the | sodium-potassium pump |
| magnesium is needed for the movement of what into the cell? | potassium |
| where is the maority of magnesium? | bone |
| what percent of magnesium remains inside the cell | 40 |
| serum magnesium levels should be | 1.5-2.5 |
| how much of dietary magnesium is absorbed in the intestine? | only 30-40% |
| what inhibits renal excretion of magnesium? | fluid volume deficit, increased PTH, reduced excretion of sodium or calcium |
| what changes during sleep might the patient with hypomagnesemia have? | increased ventricular tachycardia |
| hypomagnesemia indicates a serum magnesium level of | less than 1.5 |
| hypomagnesemia is usually caused by | reduced GI absorption, urinary loss and/or a shift of magnesium into the ICF |
| hypomagnesemia occurs after what size of magnesium deficit | small |
| small bowel bypass surgery and/or acute or chronic diarrhea can cause what changes in Mg levels | decreased |
| hypocalcemia is worsened by | hypomagnesemia |
| low levels of mg usually occur in combination with low levels of | ca & K+ |
| hypomagnesemia will cause what in the muscles? | tetany-like muscle contractions |
| when do symptoms of hypomagnesium appear? | not until levels fall below 1 |
| what are the characteristic manifestations of hypomagnesium? | muscle weakness and tremors |
| is the heart rate high or low in hypomagnesium? | high |
| what type of dysrhythmias occur in hypomagnesium? | ventricular dysrhythmias |
| magnesium deficiency....widening QRS....flattened or inverted T waves and what to the PR interval? | prolongation |
| hypomag causes what ECG changes? | wide QRS, flat or inverted T, prolonged PR |
| wide QRS....flat or inverted T...prolonged PR | hypomagnesium |
| what changes occur in the T wave when mg is low? | flat or inverted |
| mag low, T flat or | inverted |
| when mag is low what happens to the QRS | wiiiiddddeeeee |
| wide Q R S? | hypomag |
| flat or inverted T waves? | hypomag |
| prolonged PR waves? | hypomag |
| if there are deficits in calcium, potassium and magnesium, which is treated first? | calcium and potassium |
| if hypomagnesemia is severe what treatment is indicated? | IV mag replacement with continuous cardiac monitoring |
| what amount of urine needs to be present during IV mag replacement therapy? | at least 100ml/hr |
| hypotension, flushing, sweating, depressed knee jerk and respiratory depression are all signs of | hypermagnesium |
| respiratory depression is a sign of what mag disorder? | hypermag |
| depressed knee jerk reflex is indicative of what mag disorder? | hypermag |
| dignificant depression of deep tendon reflexes signals hypermagnesemia and is a precursor to what?1 | respiratory depression and cardiac arrest |
| respiratory depression and cardiac arrest usually follow what change in a patient with hypermag? | depressed deep tendon reflexes |
| in cases of tetany what is given | calcium gluconate |
| calcium gluconate comes in what form | iv, 4.5mg/10ml |
| tremors, twitching and tetany are signs of which level of mag | low |
| convulsions, tachycardia, hypertension and angina are all signs of what level of mag? | low |
| PVCs are a sign of what level of mag? | low |
| high risk factors for hypomagnesemia are | etoh, protein-calorie malnutrition, GI losses |
| confusion is caused by what Ca & Mg conditions? | hypercalcemia and hypomagnesium |
| hypomagnesium irritates the | heart |
| how should IV mag sulfate be administered? | slowly and always on a pump |
| gravity or pump for IV mag sulfate? | pump |
| a common side effect of IV mag sulfate is? | diarrhea |
| if you're constipated they tell you to get mag-citrate at store....can lead to | diarrhea |
| what foods are high in mag? | green leafy, meats, nuts, bran, legumes and fruits |
| gag reflex and swallowing capability are concerns in which mag disorder? | hypomagnesium |
| hypermagnesium is indecated by a level greater than | 2.5 |
| hypermagnesemia is common or rare? | rare |
| what is the major factor in hypermagnesemia | kidney failure |
| excess ingestion of antacids or laxatives can lead to what level of mag? | hypermag |
| what mag disorder may occur after mag sulfate adminstration to prevent seizures related to eclampsia? | hypermag |
| eclampsia...seizures....mag sulfate..... | hypermag |
| nausea, confusion, drowsiness, muscular weakness, accessory muscles used for breathing are all signs of what mag disorder? | hypermag |
| in the hypermagnesemia patient use of accessory muscles to breath can lead to | respiratory arrest |
| loop diuretics affect mg excretion how | increases |
| in the case of respiratory emergency what is administered as a magnesium antagonist? | calcium gluconate |
| what is the usual dose of calcium gluconate | 10-20ml of a 10% solution |
| if the patient is on renal dialysis what would be given in case of hypermagnesium? | magnesium free dialysate |
| if a pt has normal renal function expect to administer what if hypermagnesium occurs | oral & IV fluids |
| patients with hypermagnesium should avoid medications such as | mylanta, maalox |
| the elderly, those with renal disease and pregnant women are all at risk for what mag disorder? | hypermag |
| what vital sign changes do you report immediately with hypermag? | hypotension, respiratory depression |
Created by:
Lori Dobrisky
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