- Administer vitamin D.
- Have the patient undergo regular exercises to decrease bone loss.
Patient education should include information about dietary sources of cal-
cium, the need to maintain physical activity to avoid bone loss, avoid overuse of
antacids, and chronic use of laxatives. Patients should be taught to use fruits and
fiber for improving bowel elimination. Take oral supplements with meals or
after meals to increase absorption.Magnesium
Magnesium is a sister cation to potassium and is higher in intracellular fluid
(ICF). If there is a loss of potassium there is also a loss of magnesium. Mag-
nesium is the coenzyme that metabolizes carbohydrates and proteins and is
involved in metabolizing nucleic acids within the cell. Magnesium also has a
key role in neuromuscular excitability. The patient acquires magnesium by
ingesting magnesium-rich food, where it is absorbed in the GI tract and then
excreted in urine.
There is a close relationship between magnesium, potassium, and calcium. PTH
(see calcium), which regulates calcium, also influences the magnesium balance.
Typically, you’ll assess serum magnesium, calcium, and potassium together. The
normal serum magnesium level is between 1.5 mEq/L and 2.5 mEq/L.Hypermagnesemia
Hypermagnesemia is a condition experienced by a patient whose serum magne-
sium level is greater than 2.5 mEq/L. The major cause of hypermagnesia is an
excessive intake of magnesium salts in laxatives such as magnesium sulfate,
milk of magnesia, and magnesium citrate. Antacids such as Maalox, Mylanta,
and DiGel can also cause hypermagnesemia. Patients who take lithium (anti-
psychotic medication) are also at risk for hypermagnesemia.
The signs and symptoms of hypermagnesemia are:- Lethargy.
- Drowsiness.
- Weakness.
- Paralysis.
- Cardiac (ventricular) arrhythmias.
(^176) CHAPTER 10 Fluid and Electrolyte Therapy