Question | Answer |
Magnesium is the 2nd most abundant cation in ICF or ECF? | ICF |
Approximately 50% to 60% of body’s magnesium is contained in? | Bone |
Magnesium functions as a coenzyme in the metabolism of? | CHO and protein |
Magnesium is also involved in metabolism of? | Nucleic acid and proteins |
Magnesium is regulated by? | GI absorption and renal excretion |
Which organs are able to conserve magnesium in times of need and excrete excesses? | Kidneys |
True or False Factors that regulate calcium balance appear similarly to influence magnesium balance: | True such as PTH |
Why would manifestations of magnesium imbalance be mistaken for calcium imbalance? | Because magnesium imbalance is related to calcium and potassium balance, all three cations should be assessed together. |
Name some of the causes of magnesium imbalance Hypomagnesemia (Table 17-10 p 320): | 1. Diarrhea 2. Vomiting 3. Chronic alcoholism 4. Impaired GI absorption 5. Malabsorption syndrome 6. Prolonged malnutrition 7. Large urine output 8. NG suction 9. Poorly controlled diabetes mellitus 10. Hyperaldosteronism |
Name some of the causes of magnesium imbalance Hypermagnesemia (Table 17-10 p 320): | 1.Renal failure (especially if patient is given magnesium products) 2. Excessive administration of magnesium for treatment of eclampsi 3. Adrenal insufficiency |
Why is neuromuscular excitability profoundly affected by alterations in serum magnesium level? | Because magnesium acts directly on the myoneural junction |
How does hyermagnesemia usually occur? | Increase in magnesium intake accompanied by renal insufficiency or failure |
A patient with what kind of disease should not ingest products containing magnesium such as Maalox and MOM? | A patient with chronic kidney disease |
Initial clinical manifestations of a mildly elevated serum magnesium concentration include the following: | 1. Lethargy 2. Drowsiness 3. Nausea 4. Vomiting |
As the level of magnesium increase, describe the clinical manifestations as they become more profound: | 1. Deep tendon reflexes are loss 2. Somnolence 3. Respiratory and cardiac arrest |
Management of hypermagnesemia should focus on: | Prevention |
Persons with kidney disease should NOT take: | Magnesium containing drugs and must be cautioned to review all over the counter drug labels for magnesium content |
What is the emergency treatment of hypermagnesemia? | IV administration of calcium chloride or calcium gluconate to physiologically oppose the effects of the magnesium on cardiac muscle. |
How will promoting urinary excretion with fluid affect magnesium? | It will decrease serum magnesium levels |
The patient with impaired renal function will require dialysis. Why? | because the kidneys are the major route of excretion for magnesium |
What is the major cause of hypomagnesemia? | Prolong fasting or starvation |
What chronic activity commonly causes hypomagnesemia? | Chronic alcoholism as result of insufficient food intake. |
How does fluid loss from GI tract contribute to hypomagnesemia? | Interferes with Mg2+ absorption |
How can prolong parenteral nutrition contribute to hypomagnesemia? | Prolong parenteral nutrition without magnesium supplement hypomagnesemia |
How do many diuretics affect the level of magnesium? | Many diuretics increase the risk of magnesium loss through renal excretion |
How does osmotic diuresis affect magnesium levels? | Osmotic dieresis caused by high glucose levels in uncontrolled diabetes mellitus increases renal excretion of magnesium |
What are the clinical significant manifestations of hypomagnesemia? | 1. Confusion 2. Hyperactive deep tendon reflexes 3. Tremors 4. Seizures 5. Predispose to cardiac dysrhythmias |
Clinically, hypomagnesemia resembles what other deficiency? | Hyopcalcemia and hypomagnesemia may contribute to hypocalcemia as a result of decreased action of PTH. |
Explain how hypomagnesemia associated with hypokalemia does not respond well to potassium replacement? | This occurs because intracellular magnesium is critical to normal function of the sodium potassium pump |
Mild magnesium deficiencies can be treated with: | Oral supplements and increased dietary intake of foods high in magnesium |
List some food rich in magnesium: | 1. Green vegetables 2. Nuts 3. Bananas 4. Oranges 5. Peanut butter 6. Chocolate |
Severe magnesium deficiencies can be treated with: | Parenteral IV or IM magnesium (Magnesium sulfate). Too rapid administration of magnesium can lead to cardiac or respiratory arrest |