High Magnesium (Hypermagnesemia) Lecture Notes

Key Concept

• Magnesium's Role: Acts as a "sheriff" maintaining law and order in muscles, especially in the uterus and heart.
• Definition: Hypermagnesemia means high magnesium levels in the blood, over 2.1.

Main Causes (Acronym: DARK)

1. D - Diabetic Ketoacidosis (DKA): Drains magnesium from the body.
2. A - Antacids: Containing magnesium (e.g., Tums for heartburn).
3. R - Renal Failure: Kidneys can't excrete magnesium.
4. K - Hyperkalemia: High potassium levels due to conditions like Addison’s disease.

Physiological Effects

• Heart: Calm and quiet
  • Bradycardia (HR < 60 bpm)
  • Hypotension (low BP)
  • EKG: Prolonged PR intervals, widened QRS complexes, potential heart block.
• Lungs: Depressed, shallow respirations.
• GI Tract: Hypoactive bowel sounds, slow movements.
• Neurological Effects: Drowsiness, lethargy, progressing to coma.
• Musculoskeletal: Weakness, diminished/absent deep tendon reflexes (DTRs).

Nursing Interventions (Acronym: HIM)

1. H - Hemodialysis: Removes excessive magnesium from the body using a backup kidney.
2. I - IV Calcium Gluconate: Decreases muscle tension and irritability.
3. M - Monitor Labs: Watch for increased DTRs, indicating improvement; dietary changes recommended (avoid CAMP ON BANANAS items).

Dietary Advice (Avoid "CAMP ON BANANAS")

• C - Chocolate
• A - Avocado
• M - Milk
• P - Pork or Peas
• O - Oranges
• N - Nuts
• Bananas

Conclusion

• Summary: High magnesium affects various body systems, causing calmness and quiet, leading to potentially dangerous symptoms. Proper nursing interventions and dietary restrictions are crucial for management.