Magnesium   1.5-2.0 mEq/L

Deficiency correlated with K+, Ca, and P04

Functions

  • Neuromuscular transmission
  • Heart muscle contraction
  • Active transport

High Magnesium >2.5   (Hypermagnesium)

** Decreased Renal Function

Increased administration

  • Pre-eclampsia
  • Antiacid abuse

Symptoms???

Few before 5mEq/L

  • nonspecific-- N/V, flushing

7.5 mEq/L

  • Deep tendon reflexes

Above 12

  • Respiratory muscle paralysis
  • Will also have clinical picture of uremia

Nursing Goals

  • Monitor Mg levels and assessment with patients receiving large doses
  • Renal dialysis
  • Antidote-- Calcium gluconate

 

Low Magnesium < 1.5mEq/L    (Hypomagnesium)

Transcellular shifts

  • DKA, alcoholism, malnurtion
  • Low calcium, Low K

Excessive GI loss

  • Intestinal malabsorbtion (Chron’s Dz)

Increase Renal loss

Symptoms??

Neuromuscular

  • Muscle fasciculations and tremors
  • Apathy
  • Tetany

Cardiac

Nursing Goals

Electrolyte Replacement

 

Calcium  8.5-10.0 mg/L

Functions

  • Skeletal muscle contraction
  • Cardiac muscle contraction
  • Hardness of bone and teeth
  • Blood coagulation

Cellular permeability

PTH/Ca/P04

Hypercalcemia   Calcium >10.5 mg/L

Causes

  • Primary hyperparathyroidism
  • Some malignant tumors

Symptoms??

  • Confusion
  • Lethargy
  • Coma and death (Extreme)
  • Arrythmias ( 1st degree heart block, sinus bradycardia)
  • Shortening of ST segment

Nursing goals

Maintain hydration
      To promote calcium excretion

 

Hypocalcemia  Calcium** <8.5mg/L

Causes

  • Hypoparathyroidism
  • Target organ malfunction

Renal failure
Intestinal malabsorption
Acute pancreatitis
Malnutrition

Symptoms??

  • INCREASED neuromuscular excitability
  • Parathesias of fingers and toes
  • Muscle cramping (Extreme)
  • Irritability---psychosis
  • Severity can be related to rate of drop

Nursing goals

  • Replacement

  • Monitor for neuromuscular effects
  • Ca gluconate available