Exam 1: Magnesium Imbalances

Question 1

What does Magnesium do?

Answer 1

Acts as an activator for many intracellular enzyme systems and plays a role in both carbohydrate and protein metabolism.

Question 2

Normal Magnesium level?

Answer 2

1.3-2.3 mg/dL

Question 3

Where does Magnesium go?

Answer 3

1/3 bound to protein, and 2/3 exist as free cations.

Question 4

What happens with variations of Magnesium?

Answer 4

It affects neuromuscular irritability and contractility

Question 5

What happens with excess magnesium?

Answer 5

It diminishes the excitability of the muscle cells

Question 6

What happens with deficit of magnesium

Answer 6

Deficit increases neuromuscular irritability and contractility.

Question 7

Magnesiums affect on cardiovascular system?

Answer 7

They act peripherally to produce vasodilation and decreased peripheral resistance.

Question 8

Hypomagnesemia Range?

Answer 8

<1.8 mg/dL

Question 9

Hypermagnesemia Range?

Answer 9

> 3.0 mg/dL

Question 10

Hypomagnesemia Contributing Factors

Answer 10

Chronic Alcholism, Hyperparathyroidism, Diabetic Ketoacidosis, Refeeding after Starvation, Chronic Laxative Use , Heart Failure

Question 11

Hypomagnesemia Signs/Symptoms

Answer 11

Neuromuscular Irritability, Positive Chvostek and Trousseau Sign, Mood Changes, Anorexia, Vomiting, Increased BP

Question 12

Hypermagnesemia Contributing Factors

Answer 12

Oliguric Phase of Acute Kidney Injury

Adrenal Insufficiency, Excessive IV Magnesium, Hypothyroidism

Question 13

Hypermagnesemia Signs/Symptoms

Answer 13

Fluishing, Hypotension, Muscle Weakness, Drowsiness, Hypoactive Reflexes, Depressed Respirations, Cardiac Arrest

Question 14

What is Hypomagnesemia commonly associated with?

Answer 14

Hypokalemia and Hypocalcemia . They must all be address concurrently

Question 15

What similarity does Hypomagnesemia share with Calcium

Answer 15

1. It is the ionized frction of magnesium tha tis primarily involved in neuromuscular activity and other physiologic process
2. Magnesium levels should be evaluated in combination with albumin levels

Question 16

Hypomagnesemia Route?

Answer 16

Magnesium loss occurs in the GI Tract. This includes nasogastric sunction, diarrhea, or fistulas

Question 17

Hypomagnesemia: Where is the major site of magnesium absorption?

Answer 17

the distal small bowel. Any disruption can lead to hypomagnesemia.

Question 18

How may Hypomagnesemia occur?

Answer 18

With withdrawal from alcohol and administrationof tube feedings or parenteral nutrition

Question 19

Hypomagnesemia: Some clinical manifestations of Hypomagnesemia are due

Answer 19

directly to the low serum magnesium level; others are due to secondary changes in potassium and calcium metabolism

Question 20

Hypomagnesemia: Chvostek and Trousseau signs occur

Answer 20

in part, because of accompanying hypocalcemia

Question 21

Hypomagnesemia: Urine Magnesium May help

Answer 21

identify the cause of magnesium depletion and levels are measured after a loading dose of magnesium sulfate is given

Question 22

Hypomagnesemia: Medical Management: Diet

Answer 22

Mild Magnesium deficiency cna be corrected by diet alone.

Question 23

Sources of magnesium?

Answer 23

Green leafy vegetables, nuts, seeds, legums, whole grains, seafood, peanut butter, and cocoa

Question 24

Hypomagnesemia: Vital Signs must be assessed frequently during magnesium administration to

Answer 24

detect changes in cardiac rate or rhythm, hypotension, and respiratory distress.

Question 25

What is Hypermagnesemia?

Answer 25

It's a rare electrolyte abnormality because the kidneys efficiently excrete magnesium.

Question 26

Hypermagnesemia: Most common type of how this occurs?

Answer 26

This is kidney injury. Another common type is lithium intoxication and extensive soft tissue injury or necrosis

Question 27

Hypermagnesemia: Acute elevation of magnesium causes

Answer 27

a depression of the central nervous system as well as the peripheral neuromuscular junction

Question 28

What can occur when Hypermagnesemia is very elevated?

Answer 28

Coma, Aatrioventricular Heart Block, and Cardiac Arrest

Question 29

Hypermagnesemia: What else is present when this is elevated?

Answer 29

Elevated levels of potassium and calcium as well

Question 30

Hypermagnesemia: Medical Management

Answer 30

This can be prevent by avoiding the administration of magnesium to patients with kidney injury

Question 31

Another major cause of symptomatic hypomanesemia in the United States is

Answer 31

chronic alcohol abuse

Question 32

Serum magnesium should be measured when for people going through alcohol withdrawal

Answer 32

2-3 days

Question 33

Hypomagnesemia symptoms do not occur until level has dropped below

Answer 33

1.8

Question 34

Hypomagnesium may be accompanied by marked alterations in psychological status such as

Answer 34

Apathy , depressed mood, apprehension, and extreme agitation Dizziness Insomnia and Confusion

Question 35

What must be addressed in addition to low serum magnesium levels?

Answer 35

Concurrent hypokalemia and hypocalcemia. These are difficult to correct until magnesium has been repleted

Question 36

Hypomagnesium: If necessary, magnesium salts can be given

Answer 36

orally in an oxide or gluconate form to replace continuous losses but may produce diarrhea

Question 37

Hypomagnesium: A bolus dose of mangesium sulfate given too rapidly can produce alterations in

Answer 37

cardiac conduction leading to heart block or astyole

Question 38

Hypomagnesium: Monitoring what is essential before, during, and after administration of magnesium?

Answer 38

Urine output. Physician notified if urine volume decreases to less than 100 mL over 4 hours.

Question 39

Hypermagnesium: What happens when serum magnesium levels exceed 10 mEq/L?

Answer 39

Respiratory center is depressed. Coma, atrioventricular heart block, and cardiac arrest can occur as well.

Question 40

Hypermagnesium: Administration of what enhances magnesium excretion?

Answer 40

Loop diuretics andSodium Chloride or LActated Ringer Solution

Question 41

Hypermagnesium: What does IV Calcium Gluconate do?

Answer 41

Anatagonizes the cardiovascular and neuromuscular effects of magnesium

Question 42

Hypermagnesium: If present, nurse monitors the

Answer 42

vital signs, noting hypotension and shallow respiration . Allow decreased deep tendon reflexes and changes in consciousness.

Question 43

Magnesium produces its sedative effect at the neuromuscular junction probably by

Answer 43

inhibiting the releases of the neutrotransmitter acetycholine. Also increases the stimulus threshold in nerve fibers

Question 44

Magnesium acts directly on the

Answer 44

myoneural junction. Important for neuromuscular function