Are you studying hypomagnesemia 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 hypomagnesemia 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.
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In this article you will learn:
Normal Magnesium Level
Causes of Hypomagnesemia
Signs & Symptoms of Hypomagnesemia
Nursing Interventions for Hypomagnesemia
Teaching Tutorial on Hypomagnesemia
Hypomagnesemia
Hypo: “under”
Magnes: prefix for magnesium
Emia: blood
Meaning of Hypomagnesemia: Low levels of magnesium in the blood
Normal Levels of Magnesium: 1.6 to 2.6 mg/dL (<1.6 hypomagnesemia)
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 hypomagnesemia, the release of calcium is inhibited and that is why you will see hypocalcemia if you have low 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 Hypomagnesemia
Remember “Low Mag”
Limited intake Mg+ (starvation)
Other electrolyte issues are associated with a low Mg. level like hypOkalemia, hypOcalcemia)…it’s important to note that hypercalcemia can lead to a low magnesium level because a high calcium level causes the kidneys to not reabsorb magnesium (hence dropping the levels).
Wasting Magnesium kidneys (loop and thiazide diuretics & cyclosporine…stimulates the kidneys to waste Mag)
Malabsorption issues (Crohn’s, Celiac, proton-pump inhibitors drugs “Prilosec, Nexium, Protonix”…drug family ending in “prazole” Omeprazole, diarrhea/vomiting)
Alcohol (due to poor dietary intake, alcohol stimulates the kidneys to excreted mag, acute pancreatitis)
Glycemic issues (Diabetic Ketoacidosis, insulin administration)
Signs & Symptoms of Hypomagnesemia
Remember “Twitching” because the body is experiencing neuromuscular excitability. This is the OPPOSITE in hypermagnesemia where everything system of the body is lethargic.
Trouesseau’s (positive due to hypocalcemia)
Weakness
Irritability
Torsades de pointes (abnormal heart rhythm that leads to sudden cardiac death…seen in alcoholism) Tetany (seizures)
Cardiac changes (moderate loss: Tall T-waves and depressed ST segments*** severe loss: prolonged PR & QT interval (prolong of QT interval increases patient’s risk for Torsades de pointes) with widening QRS complex, flattened t-waves, Chvostek’s sign (positive which goes along with hypocalcemia)
Hypertension, hyperreflexia
Involuntary movements
Nausea
GI issues (decreased bowel sounds and mobility)
Nursing Interventions for Hypomagnesemia
- Monitor cardiac, GI, respiratory, neuro status. Place on a cardiac monitor (watching for any EKG changes prolonging of PR interval and widening QRS complex)
- May administer potassium supplements due to hypokalemia (hard to get magnesium level up if potassium level is down)
- Administering calcium supplements (oral calcium supplements w/ Vitamin-D or 10% Calcium Gluconate)
- Administer Magnesium Sulfate IV route. Monitor Mg+ level closely because patient can become magnesium toxic (***Watch for depressed or loss of deep tendon reflexes)
- Place patient in seizure precautions
- Oral forms of Magnesium may cause diarrhea which can increase magnesium loss so watch out for this
- Watch other electrolyte levels like calcium and potassium
- Encourage foods rich in Magnesium:
“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