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MAGNESIUM: Expected Reference Ranges
Magnesium |
1.3 - 2.1 mEq/L |
Hypomagnesemia |
< 1.3 mEq/L |
Hypermagnesemia |
> 2.1 mEq/L |
HYPOMAGNESEMIA: Risk Factors
GI loss |
Medications |
Alcohol use disorder |
Cisplatin |
Hypocalcemia |
Cyclosporine |
Hypokalemia |
Aminoglycoside antibiotics |
Diabetic ketoacidosis |
Diuretics |
Hyperparathyroidism |
Amphotericin B |
Malabsorption |
Total parenteral nutrition |
Laxative abuse |
Acute MI |
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HYPOMAGNESEMIA: Manifestations
Paresthesias |
Dysrhythmias |
Trousseau's sign |
Chvostek's sign |
Agitation |
Confusion |
Hyperreflexia |
Hypertension |
Insomnia |
Irritability |
Anorexia |
Nausea |
Vomiting |
Dysphagia |
HYPOMAGNESEMIA: Interventions
Seizure precautions |
Monitor swallowing |
Dietary measures & education |
Monitor urine output |
Monitor respirations |
Administer medications: IV magnesium sulfate, PO magnesium salts |
Monitor for signs of magnesium toxicity with IV replacement, and treat with calcium gluconate
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HYPERMAGNESEMIA: Risk Factors
Renal failure |
Excessive Mg++ therapy |
Adrenal insufficiency |
Laxative overuse |
Lithium toxicity |
Extensive soft tissue injury or necrosis |
HYPERMAGNESEMIA: Manifestations
Hypotension |
Drowsiness |
Bradycardia |
Bradypnea |
Coma |
Cardiac arrest |
Hyporeflexia |
Nausea |
Vomiting |
Facial flushing |
HYPERMAGNESEMIA: Interventions
Mechanical ventilation |
IV fluids (lactated Ringer's or NS) |
Monitor respirations and BP |
Monitor deep-tendon reflexes |
Administer meds: IV calcium gluconate, loop diuretics |
Magnesium should not be administered to pts in renal failure
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