Fluid & Electrolyte Q 111

---

Christoff is diagnosed with hypermagnesemia. Symptoms of her condition may include:

  

    A. Hypertension

    B. Tachycardia

    C. Hyperactive deep-tendon reflex

    D. Cardiac arrhythmias

    

    

Correct Answer: D. Cardiac arrhythmias

---

Cardiac arrhythmias are associated with hypermagnesemia. For higher values (over 12.0 mg/dL) muscle paralysis, paralytic ileus, decreased breathing rate, low blood pressure, electrocardiogram (ECG) changes including an increase in PR and QRS interval with sinus bradycardia, and atrioventricular block, coma and cardiac arrest (exceeding 15.0 mg/dL) may occur. Hypertension, tachycardia, and hyperactive reflexes are signs of hypomagnesemia.

---

Option A: A slight reduction in blood pressure and blurred vision caused by diminished accommodation and convergence can manifest. Patients with symptomatic hypermagnesemia can present different clinical manifestations depending on the level and the time in which the electrolytic disturbance has occurred.

Option B: In severe hypermagnesemia (greater than 12 mmol/dL), there is muscle flaccid paralysis, decreased breathing rate, more evident hypotension and bradycardia, prolongation of the P-R interval, atrioventricular block, and lethargy are common. Coma and cardiorespiratory arrest can occur for higher values (over 15 mg/dL).

Option C: The most frequent symptoms and signs may include weakness, nausea, dizziness, and confusion (less than 7.0 mg/dL). Increasing values (7 to 12 mg/dL) induce decreased reflexes, worsening confusional state, drowsiness, bladder paralysis, flushing, headache, and constipation.

---