Hypomagnesemia

Description: Low magnesium levels in the body (< 1.3 mg/dL)

Risk Factors: “Low Mag” S/S:

- Low intake of Mg+ (starvation) - Positive Trousseau’s & Chvostek’s sign
- Other electrolyte disorders (Hypokalemia/calcemia) - Muscle twitches, tetany
- Wasting of Mg+ from medications (loop/thiazide - Hyperreflexia
diuretics, cyclosporine, aminoglycosides) - ↑ BP and HR
- Malabsorption issues (Celiacs, Crohns) - Irritability and confusion
- ALCOHOLISM - Seizures
- Glycemic issues (hyperglycemia, insulin - EKG changes (Tal T waves, depressed ST
administration) segments, Torsades de Pointes)

Nursing Interventions
- Monitor electrolyte levels, neuro status, respiratory rate, and EKG changes (place on EKG monitoring)
- Correct other electrolyte imbalances (K+ Ca2+) that can occur with it
- Administer oral Mg+ (monitor for diarrhea) and IV (monitor for HYPERMAGNESEMIA, administer via
infusion pump slowly, have calcium gluconate to reverse hypermagnesemia)

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- Increase foods high in Mg+ (avocados, green leafy vegetables, canned fish, nuts, peanut butter, milk)

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- Discontinue meds depleting Mg+

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Hypermagnesemia
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Description: High magnesium levels in the body (> 2.6 mg/dL)
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Risk Factors: “MEG” S/S:

- Mg+ containing antacids & - Lethargy & drowsiness
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laxatives - EKG changes (prolonged PR interval, widened QRS complex)

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- Excessive admin of IV mag - Cardiac arrest (if severe)

- Glomerular filtration of Mg+ is - Diminished/absent deep tendon reflexes
insufficient (renal failure) - ↓ HR & BP
- Respiratory insufficiency
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- Nausea & vomiting

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Nursing Interventions
*Calcium gluconate is the antidote to magnesium overdose
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- Monitor cardiac, respiratory, neuro, GI, renal system (place on cardiac monitor-EKG)
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- Ensure pt. Safety (lethargic/drowsy)

- Admin. Diuretics (loop & thiazide) to increase renal excretion of magnesium
- Admin. IV Calcium chloride or calcium gluconate (if prescribed) to reverse effects of magnesium
(central line preferred)
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- Restrict foods high in magnesium (avocados, green leafy veg, fish, nuts, peanut, milk)
- Avoid the use of antacids & laxatives (that contain magnesium)

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