MAGNESIUM - ELECTROLYTE IMBALANCE (HYPERMAGNESEMIA & HYPOMAGNESEMIA).pdf

Hypermagnesemia, causes, risk factors, pathophysiology, clinical manifestation, diagnostic evaluation, medical management, nursing management, Hypomagnesemia, causes, risk factors, pathophysiology, clinical manifestation, diagnostic evaluation, medical management, nursing management,

1. PREPARED BY DOLISHA WARBI

2. HYPERMAGNESEMIA:
Serum magnesium level greater than 2.6 mg/dL is known as hypermagnesemia. It is much less common than
hypomagnesemia.
CAUSES:
§Renal failure
§Excessive intake of antacids or laxatives
§Lithium therapy
§Hypothyroidism
§Addison's disease
§Adrenal insufficiency
§Depression

3. RISK FACTORS:
ØAddison's disease
ØLithium therapy
ØHypothyroidism
ØOlder adults
ØPatient who receive magnesium to control seizures
ØExcessive magnesium administered.
PATHOPHYSIOLOGY:
It affects the cardiovascular system potentially causing various complication, e.g. hypotension, heart
block etc.
t occurs in the presence of renal failure or from over use of magnesium containing antacids,
interferes with neuromuscular transmission and depresses the central nervous system.
High level of potassium in blood

4. CLINICAL MANIFESTATION:
Neuromuscular
§Confusion
§Lethargy
§Respiratory depression
§Absent tendon reflex
§Paralytic ileus
§Bladder paralysis
§Muscle weakness/paralysis
Cardiovascular
§Hypotension
§Bradycardia
§Heart block
§Cardiac arrest
Other:
•Nausea, vomiting
•Coma

5. DIAGNOSTIC EVALUATION:
Blood tests
ABG
MEDICAL MANAGEMENT:
Calcium chloride (1000 mg, 13.6 mEq of calcium) to reduce symptoms
Hydration with NS
Lasix 40~80 mg IVF
Dialysis therapy
Diuretic or water pills
Albuterol is used to reduce magnesium level.
Lower use of magnesium sulphate

6. NURSING MANAGEMENT:
§Monitor Mg levels
§Monitor respiratory rate / monitor vital signs closely
§Monitor cardiac rhythms
§Increase fluids
§IV calcium for emergencies
§IV/PO magnesium replacement, including MgSO4
§Monitor I/O and monitor the signs of complication.
§ Avoid magnesium based medications like antacids: or laxatives
§Restrict dietary intake of food high in magnesium
§Teach patient to avoid dairy products

7. HYPOMAGNESEMIA:
Hypomagnesemia is a magnesium level of less than 1.6 mg/dL. It is a common problem especially in critically ill
patients.
ETIOLOGY:
ØBurns
ØInsulin therapy
ØEndocrine diseases: Diabetes mellitus, Hyperparathyroidism, Hyperadrenocorticism
ØInadequate intake or excessive excretion
§Malabsorption
§Malnutrition
§Diarrhoea
ØRenal loss
§Loop diuretic
§Parenteral fluid therapy
ØEndocrine diseases
§DM, hyperthyroidism

8. PATHOPHYSIOLOGY:
Hypomagnesemia increases the risk of digitalis toxicity.
Myocardium deficient intracellular magnesium increases the risk of cardiac dysrhythmia or sudden
death.
Central nervous system, increased neural excitability can lead to seizures and changes in mental
status.
Increased neuromuscular excitability with weak muscles and tremors.
Deficiency of magnesium

9. CLI NICAL MANIFESTATION:
Gastrointestinal:
•Dysphagia
•Anorexia
•Nausea
•Vomiting
•Diarrhoea
Neuromuscular:
•Muscle weakness, tremor
•Tetany and seizures
Cardiovascular:
•Atrial and ventricular dysrhythmias.
•Tachycardia
•Hypertension

10. Diagnostic Evaluation:
qPhysical examination
qMedical history
qBlood test
qECG
Medical Management:
qOral magnesium supplements and increased intake of dietary magnesium
qMagnesium is added to intravenous total parenteral nutrition
qOral magnesium in the form of magnesium antacids

11. NURSING MANAGEMENT:
ØMonitor vital signs
ØAdministered magnesium supplement to the patient
ØMonitor the respiratory problems
ØMonitor I/O of the patient closely
ØEducate the patient about he condition and provide knowledge about he dietary pattern.
ØClosely monitor the patient condition and the signs of complication.

12. THANKS YOU