A nurse is assessing a client who has hypermagnesemia. Which of the following medications should the nurse prepare to administer?
A.
Calcium gluconate
B.
Flumazenil
C.
Acetylcysteine
D.
Protamine sulfate
The Correct Answer and Explanation is:
The correct answer is A. Calcium gluconate.
Explanation:
Hypermagnesemia is an elevated level of magnesium in the blood, which can occur due to various conditions such as excessive intake of magnesium-containing medications, renal insufficiency, or adrenal insufficiency. It can lead to serious symptoms including muscle weakness, lethargy, and in severe cases, cardiac arrhythmias or cardiac arrest.
Calcium gluconate is used as a treatment for hypermagnesemia because it helps to counteract the effects of elevated magnesium levels on the heart and neuromuscular system. Magnesium and calcium have an antagonistic relationship in the body; high levels of magnesium can impair calcium function, potentially leading to cardiac and neuromuscular complications. Administering calcium gluconate helps to stabilize the cardiac membrane and reduce the risk of arrhythmias, thereby mitigating the symptoms of hypermagnesemia.
Here’s how calcium gluconate works in this context:
- Cardiac Protection: Magnesium acts as a competitive antagonist of calcium at the neuromuscular junction and cardiac cells. By providing calcium, calcium gluconate helps to restore normal cardiac function and reduce the risk of arrhythmias caused by elevated magnesium levels.
- Neuromuscular Function: Elevated magnesium levels can cause neuromuscular issues such as muscle weakness and decreased reflexes. Calcium gluconate helps to counteract these effects by rebalancing the calcium levels, which can improve neuromuscular function.
Other Options Explained:
- B. Flumazenil: This is a benzodiazepine antagonist used to reverse the effects of benzodiazepine overdose. It is not indicated for hypermagnesemia.
- C. Acetylcysteine: This is used as an antidote for acetaminophen (paracetamol) toxicity and for chronic obstructive pulmonary disease (COPD) as a mucolytic agent. It does not address hypermagnesemia.
- D. Protamine sulfate: This is used to reverse the effects of heparin (an anticoagulant). It is not relevant for treating hypermagnesemia.
In summary, calcium gluconate is the appropriate medication for addressing the effects of hypermagnesemia, specifically for its role in cardiac and neuromuscular stabilization.