hey everyone it's Sarah with register nurse ran.com and in this video I'm going to be going over hyper magnesia in the previous video I covered hypo magnesia so in this video I want to highlight the causes the signs and symptoms and the nursing interventions with some clever pneumonics on how to remember them then I'm going to hit the highlights of things that you need to know for the inlex exam and for your nursing lecture exams now after this please go to my website register nurse rn.com to take the free quiz that will test your knowledge on the difference between hypomagnesemia and Hyper magnesia so let's get started okay whenever I have these big words of course I always like to take them apart and see which electrolyte we're talking about is it high is it low so the first part of this word is hyper and it means excessive next is magnes and that is the prefix for magnesium an emia which is the which means blood so the meaning is you put it all together you get high magnesium in the blood now what is a normal magnesium level because exams love to throw out figures and ask you what's up with this patient you have to know if it's normal or not a normal mag level is 1.6 to 2.6 and anything greater than 2.6 is considered hyper magnesia okay let's talk about the role of Mag in the level in the body because in order to truly understand these causes and these signs and symptoms you have to know how it works and then it all makes sense so how does mag work in the body it plays a huge role in transferring and storing energy in the cell huge cell function it regulates the parathyroid hormone which is responsible for calcium levels in the body and it metabolizes your carbs fats and proteins and regulates blood pressure now where is this electrolyte absorbed it is absorbed in the small intestine so anything that causes any malabsorption issues anything like that can throw off your mag levels and it's excreted in the kidneys so if you have any renal issues anything like that you can either waste too much magnesium or you can keep too much magnesium and we'll talk about that here in a second so those two things play a huge role in magnesium okay so what are the causes of hyper magnesia okay key thing to remember with this is the three little word mag now Ma High mag levels are not very common it's a lot less common than hypomagnesemia which is what we covered in the video before typically whenever a patient is going into hypermagnesemia it is probably due because they are already high hpo meaning they were low in mag and you maybe started magnesium sulfate and it quickly increased in the mag levels too much where we didn't want them and we sent them into hyper magnesia so that's why whenever you're ad ministering mag magnesium sulfate you need to be watching those mag levels closely their deep tendon reflexes things like that but some other causes um that Tess Lov to hit on this the first part of Mag is M magnesium containing antiacids and laxatives so um say that the patient is in renal failures and they're keeping all this magnesium which we'll get to G here in a second which is talking about kidney failure and they're they have some stomach issues so they want to take maybe some Mila or Malo which is a magnesium containing anti acid this is not a good idea because these antiacids contain magnesium and their kidneys aren't going to excrete it properly and they're going to keep magnesium in their body and it's going to shoot those levels up so remember that a patients who have Addison's disease which is an adrenal insufficiency can increase mag um G for glomular filtration in insufficiency this is a fancy word for renal failure they usually have um a filtration less than 30 Mill milliliters per minute and what's happening is that the kidneys are just conserving just keeping too much magnesium so those are the causes of hypermagnesemia now what are the signs and symptoms how are these patients going to look and present and things you need to know for an exam okay let's think back to hypomagnesemia in the previous video remember everything was excited it was twitching that was the pneumonic remembered for that it was going crazy now in this everything is lethargic it's every system of the body is just tired so remember the term lethargic now patients who do have high magnesium levels you're not going to see these signs and symptoms unless it's really severe patients who normally just have a moderate a mild case they're going to have no symptoms they're going to be asymptomatic so whenever you have severe case this is what you're going to have L for lethargic you're going to have L Lethy this is just going to be really profound they're going to be really weak e EKG changes remember this this is another thing that tests like to hit on they will have a PR and a QT interval that is prolonged and a wide QRS complex t for tendon reflexes diminished or absent Commit This to Memory this is another important thing remember in hypomagnesemia these reflexes were very hyperactive here they're diminished or absent you're not going to have any H for hypotension remember magnesium regulates blood pressure so you'll have low blood pressure a for arhythmia the patients could have a braidic cardia which is a slow heart rate remember every everything's tired and lethargic so low slow um slow heart rate or a heart blocks R for respiratory arrest they can all of a sudden just go into this G uh GI issues like nausea and vomiting makes them really sick I for impaired breathing this is due to the weakness of the skeletal muscle muscles which help us breathe breathe in and out um which can cause respiratory arrest and C Cardiac Arrest all of a sudden they can just go into a Le Rhythm okay the nursing interventions this is the big thing hit on exams so you want to remember this stuff okay first you want to monitor the patients's cardiac respiratory neurog gii and renal status because all of these systems are affected by the low I mean high magnesium levels um also place the patient on a cardiac monitor to look for those EKG changes that we talked about earlier ensure that the patient is safe they're not going to get hurt or injured because they're lethargic they're drowsy they're not themselves um and you want to really prevent this because there's not a lot of causes of things that can cause this unless you're giving them too much magnesium things like that so like I said earlier if the patient's in renal failure and they're having upset stomach and they want something for it be sure not to give them or watch out for anything that is a magnesium containing anti acid or laxative because this will increase their mag levels and if the patient it was in hypomagnesemia and they're receiving mag magnesium sulfate make sure that you're watching their mag levels you're assessing those deep tendon reflexes because all of a sudden if you see that those deep tendon reflexes are gone and they're really diminished you probably have a magnesium problem and you'll want to catch it early and discourage and do not let the patient eat foods that are high in magnesium and you want to remember foods that are high in magnesium because a lot of tests love to ask you give you a scenario and say which food should the patient not eat so here's this little phrase that can help you remember foods that are high in magnesium remember the phrase always get plenty of foods containing large numbers of magnesium and each letter correlates with the food a for avocado g for green leafy vegetables this is like kale spinach things like that P for peanut butter pork o for oatmeal f for fish which is like can tuna mackerel C for cauliflower or chocolate specifically dark chocolate L for legum n for nuts o for oranges and M for milk and some other things and the doctor May order some uh Loop Diuretics or thide diuretics because they waste uh magnesium and but this will not be ordered in a patient with renal failure because they're already not putting out urine and you don't want to stress the kidneys out by giving them diuretics and remember in hypomagnesemia we actually um this was a cause of low mag because these drugs drugs waste magnesium okay and if the patient is in renal failure the doctor May prescribe for them to get some dialysis to get some of that magnesium off and sometimes doctors order IV calcium which will help reverse the effects of magnesium and if that is the case watch out for um infiltration because this stuff is really hard on the tissue and a lot of times it's preferred to give in a central line rather than an IV line okay so that is a little bit about hyper magnesia now go to my website register nurse rn.com and take the free quiz that will test your knowledge on hypo and Hyper magnesia and thank you so much for watching and please consider subscribing to this YouTube channel