hi guys it's me Professor D and welcome back to my YouTube channel on this video I'm going to be covering hyper magazemia now it's important for you guys to know the therapeutic range and the therapeutic range is 1.5 to 2.5 so anything higher than 2.5 is hyper magnesemia okay uh before we get started guys as always I'm going to ask you please like this video do it not so you don't forget you know you're gonna love the video like it now subscribe to my channel if you haven't done so already please help support me and support my channel by sharing my content share it with a friend or co-worker a colleague a classmate even a nursing instructor don't forget I have audio lessons available on my website nexusnursinginstitute.com let's get started oh by the way I get lots of questions every time about this book this is a wonderful book um I encourage you to get it if you're struggling with med-surg and the book that you're using just as not doing it for you this book is medical surgical nursing by Lewis ninth Edition um it's an older book I I think they're up to 11th or 12th edition by now but the one I'm using is an older edition it's not the ninth Edition Okay so hypermagnesemia too much magnesium higher than 2.5 it's high Shear magnesium and it usually occurs look at this word only remember I told you when you're studying and there are certain keywords that you see on these one of them pay attention that means what's another word for only just this right it's very important only with increased magnesium intake accompanied by renal insufficiency or failure so the usually the only way a patient will get hypermagnesemia is if they're getting too much magnesium they're ingesting it they're getting it their body too much and the kidneys aren't working because remember the kidneys are responsible for excretion so if you're ingesting it or you're getting too much magnesium your kidneys should be functioning enough that you're able to get it out of your body you're able to excrete it via kidneys but if you're getting too much and the kidneys aren't working this is what you're going to be dealing with hypermagnesemia let's keep going a patient with chronic kidney disease who ingests products containing magnesium and they gave you examples you need to know those examples they have been seen on NCLEX many times what are those examples Maalox milk of magnesia these are high in magnesium they will have a problem with excess magnesium that makes sense patients got chronic kidney disease kidney hasn't been working the way supposed to be working for a very long time on top of that they're ingesting products that are high in magnesium it makes sense magnesium access uh could develop in pregnant women receiving magnesium sulfate for the treatment of eclampsia now if you haven't done labor and delivery yet or you haven't gotten to maternity you'll know that one of the treatments for eclampsia is magnesium why something you guys have to understand about magnesium it relaxes those muscles magnesium relaxes the muscles and nerves so that woman who has eclampsia they want to make sure that they relax those muscles right they don't want her to go into seizures um it helps prevent lots of issues so something about magnesium it relaxes the muscles and nerves you have to know that okay so where were we so it can happen to women who are taking magnesium sulfate for the treatment of eclampsia or in patients that are taking laxatives and antacids that contain magnesium so we have to be very careful with that look at what magnesium does it impairs nerve and muscle function whenever you think of magnesium I want you to think of relaxing of the nerve and muscle function at first the initial manifestations include hypotension facial flushing lethargy urinary retention they're holding on to all that urine in the bladder because remember it's the muscles of the bladder that squeezes that urine out right but because of hypermagnesemia they have muscle and nerve what relaxation urinary tension nausea vomiting as a serum magnesium increases deep tendon reflexes are lost they won't have them anymore because of that muscle and nerve relaxation followed by look at this muscle paralysis coma respiratory and cardiac arrest can occur because the last time I checked it was the respiratory muscles that helped the lungs to expand so you can breathe and last time I checked the heart's a big what muscle so it could cause muscle relaxation to the point that that heart just stops so management it begins with avoiding magnesium containing drugs and we already have those examples remember the Maalox milk of magnesium um laxatives that contain antacids you're going to teach the patient to limit the diet intake of magnesium-containing foods let me tell you something whenever you guys have an example you're studying and they give you example make sure you know those examples usually those examples show up on your nursing exams as select all that applies all right so what are those examples green vegetables nuts bananas oranges peanut butter chocolate they are high in magnesium so that patient with hypermagnesemia you have to tell them to stay away from those types of foods now if the kidney is working properly the kidney function is good you're going to increase fluids and diuretics to promote urinary excretion to help get rid of that excess magnesium okay but remember you're only going to push fluids and give them diuretics if the kidneys can handle it if the kidneys are functioning properly if the patient with impaired renal excuse me the patient with impaired renal function we're going to do dialysis that's how we're going to get rid of um all of the Magnesium because if their kidneys aren't functioning properly number one we can't force floors we're going to mess around and give that patient fluid overload because they're not going to get rid of the fluid because the kidney is not working and number two we're not going to give them diuretics because those diuretics are dependent on the kidneys actually functioning so if the kidney is not functioning instead of giving them fluids and diuretics we expect what dialysis if hypermagnesemia is symptomatic that means the patient has hyper magnesemia and we're seeing those symptoms that we went over such as the you know the decreased tendon reflexes or even the muscle paralysis things like that if they're symptomatic giving IV calcium gluconate that will help it will oppose the effects of the excess magnesium on the cardiac muscle so this is another treatment option if that patient is symptomatic we expect for calcium gluconate to be ordered for that patient for hypermagnesemia now one more thing let's go over this table the ones I put the star next to those are the ones that tend to show up more on nursing exams so guys I don't write your test so don't go in the comment section and say Professor D this was not on it or whatever I don't write your exams but I'm just telling you there's a pattern okay and the ones I put a star next to are the ones that tend to show up more on nursing exams make sure you know them so for hypermagnesemia let's look at the causes renal failure number one the kidneys can't get rid of all that magnesium what else um IV administration of magnesium remember ivy goes straight into the bloodstream you don't have to worry about it being um metabolized or processed and going through you know the GI tract going through the liver it goes directly into the bloodstream so of course that could cause hyper magnesemia and look at this antacids or laxatives that contain a magnesium right manifestations remember I want you to think of muscle and nerve relaxation so lethargy drowsiness muscle weakness urinary retention diminish or absent deep tendon reflexes decrease pulse decrease blood pressure everything goes down all right guys that's your hypermagnesemia in a nutshell it's not as hard as we all thought it was so make sure you guys know this information so you can Ace your next exam let me know what you thought about this video in the comment section please let me know if there's anything you'd like to see me covered that I have not done so already very soon I think I have the date for my next NCLEX uh life that I'm gonna do on YouTube but I have to have just two more things I need to check on to confirm but I will be making that announcement either today or tomorrow on my next NCLEX review live it's free guys it's just something I'm doing to help you guys out so I hope you can make it I'll be giving the date for that shortly thank you so much for watching my video and you guys will catch me on the next video