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Hypomagnesemia & Hypermagnesemia Cheat Sheet by

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
 

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
 

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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