Hypermagnesemia (Easy Breakdown!)

In this video, we're walking through the pathophysiology and the signs and symptoms that you might see in a patient with hypermagnesemia or a high magnesium level. I'll give you a super easy breakdown of what happens and why so that you can learn it faster and pass your nursing school exams. Let's dive in. Now before we get started, something you need to know right out of the gate is that when you are studying fluids and electrolytes, it is a lot of critical thinking. Now I'll walk you through the key points that you need to know about it here in this video, but I also have a free critical thinking cheat sheet for you that you will definitely want to snag. This cheat sheet will help you critically think better and pass your nursing school exams. So I'll put the link down below in the description for you to snag that after you watch this video. So a normal magnesium level is between 1.3 to 2.1 milli equivalents per liter. Hyper magnesemia means that the serum magnesium level is greater than 2.1 milli equivalents per liter. So let's start off with the pathophysiology of hypermagnesemia and what could cause it. It would be very hard to get too much magnesium from diet alone since it is so effectively regulated by the kidneys as long as the kidneys are functioning. So instead of getting too much magnesium from food sources, it is typically a result of ingesting too much magnesium containing medications like some laxatives or antacids or just magnesium supplementations themselves. Or it can happen after an acute kidney injury or chronic renal failure where the kidneys are damaged and they're not processing and filtering out the magnesium enough. Hypermagnesemia can also be caused by tumor lysis syndrome, when a lot of blood cells burst. Since magnesium likes to mostly hang out inside the cell, it can move outside of the cell when those cells burst or break, which will increase that serum magnesium level. Now let's talk about magnesium's role in the body. So the pathophysiology behind what's happening here in hypermagnesemia. We'll cover a lot here, so be sure to check out the study guide that we have for you inside the nursing SOS membership community so that you can remember all of this and really better understand it. We have a full fluids and electrolytes course for you inside the community which gives you a fantastic breakdown of each of the electrolyte disorders that you need to know about. For Your nursing school exams. I'll put a link to that in the description below for you to check out all of the details. So magnesium is absorbed in the GI tract. It's stored in the bones and inside cells, and then it's excreted and regulated in the kidneys. Now, magnesium plays numerous roles in the body, but the two main functions that you need to know are regulating the release of parathyroid hormone and inhibiting neurons and muscles. So magnesium regulates the secretion of parathyroid hormone, or pth, which affects the calcium concentration in the bloodstream. If there is too much magnesium in the blood, it will inhibit the secretion of pth, and that inhibits calcium, causing hypocalcemia. So magnesium and calcium are opposites. So magnesium also inhibits the release of acetylcholine by preventing calcium from entering neurons and allowing them to fire. Acetylcholine is a neurotransmitter responsible for muscle contraction as well as a lot of central nervous system functions. And calcium is required for neurons to fire. So by blocking that calcium, magnesium helps to dampen the central nervous system and the muscles. Now at normal levels. This is helpful to maintain and control overexcitability of the cells and prevent them from firing randomly. However, when there's too much magnesium, it further inhibits acetylcholine release. And that can block the neuronal transmission that slows down muscle contractions throughout the body, including the heart, the respiratory muscles, and the smoot muscles of the blood vessels. And it can slow down the neuronal processes in the brain as well. So be sure to remember those two main functions of magnesium, okay? It regulates the release of parathyroid hormone and it inhibits neurons and muscles. Because as we go through these signs and symptoms of hyper magnesemia, they will have to do with these two main functions. Now, you know me and you know how we all always connect the signs and symptoms back to the pathophysiology and what is going on in the body. It's just not helpful for you to memorize a list of signs and symptoms. And there's a way easier way, my friend. This is exactly how I teach inside the nursing SOS membership community, because it works. Instead of just memorizing a list of things, we're going to really critically think and connect the dots between the concepts, which is exactly what your nursing exams are going to test you on. So let's walk through the signs and symptoms of hyper magnesemia. We'll connect them back to the pathophysiology. So you can understand what's happening with them. So since the neurons and the muscles within the heart are slower, the patient may have ECG changes and arrhythmias, including heart blocks, a prolonged PR interval and a wider QRS complex. Now, hypotension or a low blood pressure can happen for that reason, too. The blood vessels, they're relaxing, they're vasodilating because all of that magnesium is inhibiting the muscles and those neurons from firing a respiratory distress and respiratory failure. It can happen if the respiratory muscles are slowed down to the point of not working as effectively to ventilate the patient. It usually won't happen suddenly, but over time, as the respiratory muscles continue to slow down, it could lead to apnea or a pause or stop in breathing. And overall muscle weakness and lethargy, along with diminished or absent reflexes, can also the neurons and the muscles are inhibited all throughout the body, so they are all just slower and weaker than usual. Then mental status changes can occur, like dizziness, confusion, and can even lead to a coma. Now this makes sense since the neurons aren't firing like they should, they're so suppressed, right, that the brain and that central nervous system, it just can't function as well as it's supposed to. And then nausea and vomiting can occur too, due to the overall slowing of those muscles in the GI tract. And finally, hypo calcemia or a decreased calcium level happens because all that magnesium is inhibiting that PTH from being released. So remember, when magnesium is high, PTH is suppressed and calcium falls. So they are opposites of each other. So the key thing to remember here, magnesium regulates the release of parathyroid hormone and can actually inhibit it, and it also inhibits neurons and muscles. So when magnesium is too high, that PTH release, the muscles and the neurons are suppressed. Now, it's not just electrolytes that you're going to be tested on in nursing school, you will also be tested on IV fluids a lot as well. So you really need to know them. So click on this video here and I will walk you through everything you need to know about IV fluids so you can pass your exams. And if you love this video, write love in the comments below. And as always, my friend, go become the nurse that God created only you to be. And I will see you over there in that next video.