Hypomagnesemia (Exam 4)

Hypomagnesemia

Exam 4

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A. Description -

» Hypomagnesemia is a serum magnesium level lower than 1.6 mg/dL

B. Causes -

» 1. Insufficient magnesium intake

• a. Malnutrition and starvation

• b. Vomiting or diarrhea

• c. Malabsorption syndrome

Saunders

• d. Celiac disease

ATI - Overview (Hypomagnesemia)

B. Causes - continued

• e. Crohn’s disease

» 3. Intracellular movement of magnesium

• a. Hyperglycemia

Hypomagnesemia is a serum magnesium level less than 1.3 mg/dL.

C. Assessment

» 2. Increased magnesium secretion

• b. Insulin administration

• c. Sepsis

• a. Medications such as diuretics

Assessment

• b. Chronic alcoholism

■Risk Factors

» Causes of hypomagnesemia-

• Malnutrition (insufficient magnesium intake)

• Alcohol ingestion (magnesium excretion)

» Increased magnesium output-

• GI losses (diarrhea, nasogastric suction)

• Thiazide or loop diuretics

» Inadequate magnesium intake or absorption:

• Malnutrition

• Alcohol use disorder

• Laxative use

Subjective and Objective Data

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» Neuromuscular -

D. Interventions -

• Increased nerve impulse transmission (hyperactive deep-tendon reflexes, paresthesias, muscle tetany), positive Chvostek’s and Trousseau’s signs

» 1. Monitor cardiovascular, respiratory, gastrointestinal, neuromuscular, and central nervous system status; place the client on a cardiac monitor

» Gastrointestinal –

» 2. Because hypocalcemia frequently accompanies hypomagnesemia, interventions also aim to restore normal serum calcium levels

• Hypoactive bowel sounds, constipation, abdominal distention, paralytic ileus (also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include: Bacteria or viruses that cause intestinal infections [gastroenteritis])

» 3. Oral preparations of magnesium may cause diarrhea and increase magnesium loss.

» Cardiovascular–

» 4. Magnesium sulfate by the IV route may be prescribed in severe cases (intramuscular injections cause pain and tissue damage); initiate seizure precautions, monitor serum magnesium levels frequently , and monitor for diminished deep tendon reflexes, suggesting hypermagnesemia, during the administration of magnesium.

• dysrhythmias, tachycardia, hypertension

Trousseau's sign is a carpal spasm induced by inflating blood pressure cuff above the systolic pressure for a few minutes

Trousseau's sign is a carpal spasm induced by inflating blood pressure cuff

Chvostek's sign is contraction of facial muscles in response to a light tap over the facial nerve in front of the ear

» 5. Instruct the client to increase the intake of foods that contain magnesium.

Patient-Centered Care

Saunders

Foods Enriched in Magnesium to Increase

Nursing Care -

» Discontinue magnesium-losing medications (e.g., loop diuretics).

» Administer oral or IV magnesium sulfate following safety protocols. IV route is used because IM can cause pain and tissue damage. Oral magnesium can cause diarrhea and increase magnesium depletion. Monitor the client closely.

» Encourage foods high in magnesium, including dairy products and dark green vegetables.

» Implement seizure precautions.s.

Patient-Centered Care

Teamwork and Collaboration -

» Endocrinology may be consulted for electrolyte and fluid management.

» Respiratory services may be consulted for oxygen management.

» Nutritional services may be consulted for food choices high in magnesium.

» Cardiology may be consulted for dysrhythmias.

Care After Discharge -

» Client Education

• Educate the client regarding foods that are high in magnesium.

• Teach the client ways to increase magnesium in diet by reading food labels.