Hypomagnesemia Lecture Notes

Definition

Hypomagnesemia: Low levels of magnesium in the blood.
- "Hypo" means low.
- "Magnus" refers to magnesium.
- "Emia" means in the blood.
Normal magnesium levels: 1.5-2.5 mg/dL.
Hypomagnesemia: Magnesium level less than 1.5 mg/dL.

Absorption and Excretion
- Absorbed in the small intestine.
- Excreted via kidneys.
Chronic Alcoholism
- Most common cause in the U.S.
- Alcohol causes kidneys to waste magnesium.
Loss from GI Tract
- NG tube suction, diarrhea, vomiting, fistulas.
- Use of diuretics.
Malabsorption Issues
- Crohn's disease, celiac disease, malabsorption syndrome.
Limited Intake
- Starvation, enteral, and parenteral feeding.
- These feedings often lack magnesium.
Increased Blood Sugar Levels
- Hyperglycemia and DKA.

Magnesium acts like a sedative.
Low magnesium = increased energy/neuromuscular excitability.
Neuromuscular Symptoms
- Tremors, muscle cramps, weakness.
- Rigid, tight muscles.
- Increased deep tendon reflexes (DTRs).
CNS Symptoms
- Irritability, insomnia, confusion, seizures.
Cardiac Symptoms
- Increased heart rate, blood pressure, cardiac dysrhythmias.
GI and Respiratory Symptoms
- Increased GI motility (diarrhea).
- Tight, tense airway muscles causing stridor, laryngeal spasms.
- Swallowing problems due to tense esophagus.

Dietary Adjustments
- Increase intake of magnesium-rich foods:
  - Avocados, green leafy vegetables, almonds, figs, cashews, yogurt, potatoes.
Severe Deficiencies
- Treated with IV magnesium sulfate (infusion pump).
- Administer slowly to prevent hypermagnesemia.
Aspiration Precautions
- Due to swallowing problems.
Alcoholism Intervention
- Provide support and referrals for alcohol abstinence programs.
Seizure Precautions
- Oxygen and suction available.
- Ensure privacy, side rails up, and safety measures in place.
- Side-lying position post-seizure to prevent aspiration.
- Avoid restraining client or placing objects in the mouth.
- Never leave a client during a seizure.