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Hypermagnesemia NCLEX Review Notes

Are you studying hypermagnesemia and need to know some mnemonics on how to remember the causes, signs & symptoms, nursing interventions? This article will give you some clever mnemonics on how to remember hypermagnesemia for nursing lecture exams and NCLEX.

In addition, you will learn how to differentiate hypomagnesemia from hypermagnesemia. Don’t forget to take the hypomagnesemia & hypermagnesemia quiz.

 

In this article you will learn:

Normal Magnesium Level
Causes of Hypermagnesemia
Signs & Symptoms of Hypermagnesemia
Nursing Interventions for Hypermagnesemia

Teaching Tutorial on Hypermagnesemia


Hypermagnesemia

Hyper: “excessive”

Magnes: prefix for magnesium

Emia: blood

Meaning of Hypermagnesemia: High levels of magnesium in the blood

Normal Levels of Magnesium: 1.6 to 2.6 mg/dL (>2.6 hypermagnesemia)

Magnesium plays a role in: major cell functions like transferring and storing energy, regulation of parathyroid hormone PTH (which also plays a role in calcium levels). In hypermagnesemia, the release of calcium is inhibited and that is why you will see hypocalcemia if you have a high magnesium level. Magnesium also plays a role in the metabolism of carbs, lipids, and proteins, and blood pressure regulation.

Magnesium is absorbed in the small intestine and excreted via the kidneys (any issues with these systems can cause magnesium level issues).

Causes of Hypermagnesemia

Remember “MAG”

Hypermagnesemia is less common than hypomagnesemia. It typically happens when you are trying to correct hypomagnesemia with magnesium sulfate IV infusion. However, other causes can include:

Magnesium containing antacids and laxatives***(Mylanta, Maalox)

Addison’s disease (adrenal insufficiency)

Glomerular filtration insufficiency (<30mL/min) renal failure. This is because the kidneys are keeping too much magnesium.

Signs & Symptoms Hypermagnesemia

Remember: Every system of the body is “Lethargic” (opposite of hypomagnesemia where the body systems are experiencing hyper-excitability)

Note: You will typically only see symptoms in severe cases of hypermagnesemia (mild cases patient will be asymptomatic)

Lethargy (profound)

EKG changes with prolonged PR & QT interval and widened QRS complex

Tendon reflexes absent/grossly diminished

Hypotension

Arrhythmias (bradycardia, heart blocks)

Respiratory arrest

GI issues (nausea, vomiting)

Impaired breathing (due to skeletal weakness)

Cardiac arrest

Nursing Interventions for Hypermagnesemia

  • Monitor cardiac, respiratory, neuro system, renal status. Put patient on cardiac monitor (watch for EKG changes)
  • Ensure safety due to lethargic/drowsiness
  • Prevention:
  1. Avoid giving Magnesium containing antacids/laxative to patients with renal failure
  2. Assess for hypermagnesemia during IV infusions of magnesium sulfate for hypomagnesemia (sign and symptom would be diminished/absent deep tendon reflexes)
  3. Withhold foods high in magnesium, such as:

Remember: “Always Get Plenty Of Foods Containing Large Numbers of Magnesium”

  • Avocado
  • Green leafy vegetables
  • Peanut Butter, potatoes, pork
  • Oatmeal
  • Fish (canned white tuna/mackerel)
  • Cauliflower, chocolate (dark)
  • Legumes
  • Nuts
  • Oranges
  • Milk
  • Administer diuretics that waste magnesium (if patient is not in renal failure) such as Loop and Thiazide diuretics
  • Patient in renal failure patient prep for dialysis
  • IV calcium may be order to reverse side effects of Magnesium (watch IV for infiltration…prefer central line)

Quiz on Hypomagnesemia & Hypermagnesemia

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