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Questions and Answers
A nurse is reviewing a client's electrolyte panel and notes a magnesium level of 1.1 mg/dL. Which of the following assessment findings should the nurse anticipate based on this result?
A nurse is reviewing a client's electrolyte panel and notes a magnesium level of 1.1 mg/dL. Which of the following assessment findings should the nurse anticipate based on this result?
- Bounding peripheral pulses
- Hyperactive bowel sounds
- Decreased deep tendon reflexes
- Positive Chvostek's sign (correct)
The nurse is caring for a client with hypomagnesemia. Which of the following interventions should the nurse prioritize?
The nurse is caring for a client with hypomagnesemia. Which of the following interventions should the nurse prioritize?
- Monitoring deep tendon reflexes hourly during IV magnesium sulfate infusion (correct)
- Administering oral magnesium sulfate with meals
- Encouraging a diet low in potassium-rich foods
- Restricting fluid intake to prevent electrolyte dilution
A client with a history of chronic alcoholism is admitted to the hospital. Which of the following electrolyte imbalances is the client most at risk for developing?
A client with a history of chronic alcoholism is admitted to the hospital. Which of the following electrolyte imbalances is the client most at risk for developing?
- Hypomagnesemia (correct)
- Hypercalcemia
- Hyperkalemia
- Hypernatremia
The nurse is reviewing the ECG of a client with suspected hypomagnesemia. Which ECG finding is most consistent with this electrolyte imbalance?
The nurse is reviewing the ECG of a client with suspected hypomagnesemia. Which ECG finding is most consistent with this electrolyte imbalance?
A client reports muscle cramps and tingling around their mouth. The nurse notes a positive Trousseau's sign during the physical assessment. Which electrolyte imbalance is most likely contributing to these findings?
A client reports muscle cramps and tingling around their mouth. The nurse notes a positive Trousseau's sign during the physical assessment. Which electrolyte imbalance is most likely contributing to these findings?
The nurse is developing a dietary plan for a client with mild hypomagnesemia. Which of the following food choices is the best source of magnesium?
The nurse is developing a dietary plan for a client with mild hypomagnesemia. Which of the following food choices is the best source of magnesium?
A nurse is caring for a client with hypomagnesemia who is also taking digoxin for heart failure. Which of the following nursing actions is most important to prevent complications?
A nurse is caring for a client with hypomagnesemia who is also taking digoxin for heart failure. Which of the following nursing actions is most important to prevent complications?
A client with Crohn's disease is at risk for hypomagnesemia. Which pathophysiological mechanism associated with Crohn's disease contributes to this electrolyte imbalance?
A client with Crohn's disease is at risk for hypomagnesemia. Which pathophysiological mechanism associated with Crohn's disease contributes to this electrolyte imbalance?
A client with hypomagnesemia is experiencing muscle tetany and seizures. Which medication should the nurse anticipate having readily available to reverse potential complications related to treatment?
A client with hypomagnesemia is experiencing muscle tetany and seizures. Which medication should the nurse anticipate having readily available to reverse potential complications related to treatment?
The healthcare provider prescribes IV magnesium sulfate for a client with severe hypomagnesemia. Which of the following should the nurse include in the client education regarding this medication?
The healthcare provider prescribes IV magnesium sulfate for a client with severe hypomagnesemia. Which of the following should the nurse include in the client education regarding this medication?
Flashcards
Hypoactive bowel sounds
Hypoactive bowel sounds
Diminished or absent bowel sounds, indicating decreased intestinal activity.
ECG with tall, peaked T-waves
ECG with tall, peaked T-waves
ECG finding characterized by tall and pointed T-waves, often seen in hyperkalemia.
Positive Trousseau’s sign
Positive Trousseau’s sign
A sign of hypocalcemia where carpopedal spasm is induced by inflating a blood pressure cuff on the arm.
Checking for Chvostek’s sign
Checking for Chvostek’s sign
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Manifestations of hypocalcemia
Manifestations of hypocalcemia
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Hypomagnesemia
Hypomagnesemia
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Cardiovascular effects of Hypomagnesemia
Cardiovascular effects of Hypomagnesemia
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Neuromuscular effects of Hypomagnesemia
Neuromuscular effects of Hypomagnesemia
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Gastrointestinal effects of Hypomagnesemia
Gastrointestinal effects of Hypomagnesemia
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ECG changes in Hypomagnesemia
ECG changes in Hypomagnesemia
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Study Notes
- Hypoactive bowel sounds and ECG changes with tall, peaked T-waves are noted.
- Trousseau’s sign is positive.
Checking for Chvostek’s Sign
- Tap lightly on the client’s cheek to check for Chvostek’s sign.
Manifestations of Hypocalcemia
- Tingling in fingers and muscle twitching are manifestations of hypocalcemia.
Hypomagnesemia
- Blood magnesium level less than 1.3 mg/dL.
Risk Factors
- Celiac disease, Crohn’s disease, acute pancreatitis.
- Malnutrition (insufficient magnesium intake).
- Ethanol ingestion (magnesium excretion).
- Diarrhea, steatorrhea, or chronic laxative use.
- Myocardial infarction or heart failure.
- Concurrent hypokalemia and hypocalcemia.
- Medication therapy (aminoglycoside antibiotics, amphotericin B, loop diuretics).
- Pancreatitis, chronic alcoholism.
Expected Findings
- Cardiovascular: Risk for increased blood pressure and dysrhythmias.
- Neuromuscular: Hyperactive DTRs, paresthesia, muscle tetany, seizures, positive Chvostek’s and Trousseau’s signs indicate increased nerve impulse transmission.
- Gastrointestinal: Hypoactive bowel sounds, constipation, abdominal distention, paralytic ileus.
- Other: Possible depressed mood, apathy, seizures, or agitation.
Diagnostic Procedures
- Electrocardiogram changes: Prolonged QT intervals
Nursing Care
- Correct concurrent imbalance of other electrolytes to prevent worsening of either condition.
- Encourage foods high in magnesium (dark green vegetables, nuts, whole grains, seafood, peanut butter, cocoa). Use dietary changes for mild cases.
- Discontinue magnesium-depleting medications (loop diuretics, osmotic diuretics, medications that contain phosphorus).
- Administer oral magnesium sulfate for mild hypomagnesemia. Note that oral magnesium can cause diarrhea and increase magnesium depletion.
- IV magnesium sulfate is prescribed if hypomagnesemia is severe. Monitor DTRs hourly during administration.
- Monitor clients taking digitalis closely if magnesium is low because it predisposes the client to digitalis toxicity.
- Have calcium gluconate readily available to reverse hypermagnesemia.
Interprofessional Care
- Endocrinology can be consulted for electrolyte and fluid management.
- Respiratory services can be consulted for oxygen management.
- Nutritional services can be consulted for food choices high in magnesium.
- Cardiology can be consulted for dysrhythmias.
Client Education
- Intake foods that are high in magnesium.
- Increase magnesium in diet by reading food labels.
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