Nursing interventions for a patient with hypermagnesemia include administering calcium gluconate to:
A. Increase calcium levels.
B. Antagonize the cardiac effects of magnesium.
C. Lower calcium levels.
D. Lower magnesium levels.
Correct Answer: B. Antagonize the cardiac effects of magnesium.
In a patient with hypermagnesemia, administration of calcium gluconate will antagonize the cardiac effects of magnesium. Calcium may moderate nerve and muscle performance in hypermagnesemia. Calcium gluconate (Kalcinate) directly antagonizes neuromuscular and cardiovascular effects of magnesium. Use in patients with symptomatic hypermagnesemia that is causing cardiac effects or respiratory distress.
Option A: Although calcium gluconate will raise serum calcium levels, that is not the purpose of administration. Calcium gluconate is a medication used in the management of hypocalcemia, cardiac arrest, and cardiotoxicity due to hyperkalemia or hypermagnesemia. It is classified as a calcium salt.
Option C: Calcium gluconate does not lower calcium levels. The treatment of hypocalcemia initially focuses on symptomatic treatment rather than normalizing serum calcium. In severe hypocalcemia with seizures, laryngospasm, hypotension, or tetany, patients should receive emergent parenteral calcium gluconate to replenish calcium levels until severe and life-threatening abnormalities resolve.
Option D: Calcium gluconate does not lower magnesium levels. It is essential to check magnesium levels during calcium repletion as hypomagnesemia is a crucial cause of hypocalcemia. Hypomagnesemia causes hypocalcemia through impairment of parathyroid hormone secretion and renal resistance to parathyroid hormone, leading to decreased renal reabsorption of calcium.
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