Fluid Electrolyte imbalance: Magnesium

Magnesium

1.5-2.5 mEq/L

Function:

Activates intracellular enzyme systems and plays role in CHO & protein metabolism

Hypomagnesemia

Values:

          <1.5

Causes:

·                    ↓ intake or ↓absorption or excessive loss

               through urinary or bowel elimination

·              Acute pancreatitis, starvation, malabsorption

        syndrome, chronic alcoholism, burns,  

        prolonged  hyperalimentation without

        adequate Mg

·              Hypoparathyroidism with hypocalcemia

·              Diuretic therapy

Signs and symptoms:

·              Tremors, tetany, ↑reflexes, paresthesias of feet

         and legs, convulsions

·             +babinski, Chvosteck and Trousseau signs

·             Personality changes with agitation, depression or

        confusion, hallucination

·             ECG changes (PVC’s, Ventricular tachycardia,

         Ventricular Fibrillation)

Treatment:

               Mild:

·              Diet: best sources are unprocessed cereal

              grains, nuts, legumes, green leafy

              vegetables, dairy products, dried fruits,

              meat, fish

·              Magnesium salts

               More severe:

·              MgSO4 IM

·              MgSO4 IV slowly

--- --- ---

·               Monitor Mg q 12 hrs

·               Monitor VS, knee reflexes

·               Precautions for seizures/confusions

·               Check swallow reflex

Hypermagnesemia

Values:

              >2.5mEq/L

Causes:

            Most common cause:  Renal failure (esp. If taking

            large  amounts of Mg-cntaining antacids or

            cathartics; DKA with severe water loss

Signs and symptoms:

·           Hypotension

·           Drowsiness

·           Absent DTR’s

·           Respiratory depression

·           Coma

·           Cardiac arrest

·           ECG – Bradycardia, CHB, cardiac arrest,

             tall T-  waves

Treatment:

·           Withholding Mg-containing products

·           Calcium chloride or gluconate IV for acute

     symptoms

·           IV hydration and diuretics

·           Monitor VS, LOC

·           Check patellar reflexes