A nurse is assessing a client who has hypermagnesemia.
Which of the following medications should the nurse prepare to administer?
A.
Calcium gluconate.
B.
Acetylcysteine.
C.
Flumazenil.
D.
Protamine sulfate.
The Correct Answer and Explanation is:
The correct answer is A. Calcium gluconate.
Explanation:
Hypermagnesemia is an electrolyte imbalance characterized by an abnormally high concentration of magnesium in the blood. Magnesium plays an essential role in neuromuscular and cardiovascular functioning, but elevated levels can result in dangerous symptoms such as muscle weakness, lethargy, hypotension, bradycardia, respiratory depression, and even cardiac arrest. Typically, hypermagnesemia occurs in clients with renal failure, as the kidneys are primarily responsible for magnesium excretion. Other causes include excessive magnesium intake from medications like antacids or laxatives.
Why Calcium Gluconate is the Correct Choice:
Calcium gluconate is a first-line treatment for severe hypermagnesemia. It acts as an antidote by countering the neuromuscular and cardiovascular effects of excess magnesium. Magnesium is a natural calcium antagonist, meaning that elevated magnesium levels can inhibit calcium channels and disrupt normal cellular functions. By administering calcium gluconate, the nurse helps stabilize the cardiac and neuromuscular membranes, which can alleviate symptoms like hypotension and cardiac arrhythmias. This is crucial, as severe hypermagnesemia can lead to life-threatening cardiac complications, including asystole.
Why the Other Options Are Incorrect:
- B. Acetylcysteine: This is an antidote used primarily for acetaminophen (Tylenol) overdose and works by replenishing glutathione levels in the liver. It is not used for hypermagnesemia treatment.
- C. Flumazenil: This is an antidote for benzodiazepine overdose. Flumazenil works by reversing the sedative effects of benzodiazepines but has no role in managing hypermagnesemia.
- D. Protamine sulfate: This medication is used to reverse the effects of heparin, an anticoagulant. It is irrelevant in the treatment of electrolyte imbalances such as hypermagnesemia.
In summary, calcium gluconate is the appropriate medication to administer because it effectively mitigates the cardiac and neuromuscular effects of elevated magnesium levels, ensuring the client’s stability until further treatment, such as dialysis, can reduce magnesium levels in the body.