Master Hypomagnesemia with Picmonic for Physician Assistant

Decreased levels of serum magnesium depresses CNS function and affect the patient's mental clarity. Hypomagnesemia may cause occasional or frequent confusion and disorientation. Frequently assess the patient's neurologic status to monitor for increased confusion.

Deep tendon reflexes determines the muscle's ability to stretch while indicating proper functioning of the nervous system. Hypomagnesemia will increase neuronal impulses causing increased neuromuscular activity. This action will result in increased deep tendon reflexes.

Magnesium helps regulate the nervous system. Hypomagnesemia causes neuromuscular irritability characterized by seizures, muscle cramps, and tremors.

Low levels of magnesium may cause abnormal electrical activity in the brain. Disrupted brain electrical activity may result in seizures (refer to the Picmonic on "Seizure Precautions").

Magnesium helps facilitate muscle contraction and relaxation. Low levels of serum magnesium causes abnormal muscle contractions and lead to muscle cramps.

Magnesium is necessary to help stabilize neuromuscular excitability and contractility. Low levels of serum magnesium decrease the threshold of axon stimulation and increase the speed of nerve conduction. Increased neuronal activity may trigger tremors.

Magnesium helps relax muscles, calm nerves, and decrease the affects of stress and anxiety. Patients with low levels of magnesium may have difficulty sleeping and develop insomnia. Hypomagnesemia may cause the patient to sleep less deeply or wake up frequently during the night.

A deficiency in magnesium may cause cardiac arrhythmias and tachycardia. Since magnesium is necessary for muscle contraction and relaxation, decreased levels affects the heart's ability to contract. Tachycardia occurs to compensate the heart's inability to control its electrical impulses. A small percentage of patients with hypomagnesemia experience hypertension.

Mild magnesium deficiency may be managed with oral supplements. In severe cases of hypomagnesemia, IV magnesium sulfate may be given. Since rapid infusion of magnesium may cause cardiac arrest, the drug is slowly administered using an infusion pump. Since the medication may cause respiratory depression, monitor the patient's respiratory status for symptoms for abnormal breathing patterns or decreased respiratory rate.

To increase serum magnesium levels, encourage the patient to increase dietary consumption of foods high in magnesium. Foods rich in magnesium include green vegetables, nuts, bananas, oranges, peanut butter, and chocolate.