Medical-surgical Nursing Demystified

(Sean Pound) #1

CHAPTER 11 Fluids and Electrolytes^437


PROGNOSIS


Correction of the magnesium level is necessary to prevent life-threatening com-
plications. Patients are at significant risk for cardiac arrest as the magnesium lev-
els continue to rise.


HALLMARK SIGNS AND SYMPTOMS



  • Bradycardia due to slowed cellular response to normal stimuli

  • Hypotension due to vasodilation

  • Drowsiness or lethargy

  • Weakness

  • Less-than-normal deep tendon reflexes

  • Confusion

  • Urinary retention

  • Cardiac arrest when level severely elevated


INTERPRETING TEST RESULTS



  • Blood serum magnesium levels > 2.5 mEq/L.

  • EKG shows widened QRS complex, prolonged PR intervals.

  • BUN elevation if there is renal insufficiency.


TREATMENT



  • Administer magnesium antagonist intravenously:

    • calcium chloride



  • Administer Loop diuretic to reduce magnesium level:

    • furosemide



  • Dialysis—hemodialysis or peritoneal, to remove excess magnesium (espe-
    cially in patients with renal failure).

  • Reduce magnesium in diet (avoid meat, legumes, dark green leafy vegetables,
    fish, whole grains, nuts).

  • Increase fluid intake to maintain hydration.

Free download pdf