Question

a nurse is caring for a client who has a magnesium level of 3.1 meq/l (1.3 to 2.1 meq/l). the nurse should expect to administer which of the following medications?

magnesium gluconate
cinacalcet
calcium gluconate
regular insulin

Explanation:

Analyze the laboratory value

The client's magnesium level is \(3.1\text{ mEq/L}\). The normal reference range is \(1.3\text{ to }2.1\text{ mEq/L}\). This indicates the client has hypermagnesemia (elevated magnesium levels).

Identify clinical manifestations and risks

Severe hypermagnesemia can lead to neurological depression, loss of deep tendon reflexes, respiratory depression, and cardiac arrest.

Determine the pharmacological intervention

To antagonize the neuromuscular and cardiac effects of severe hypermagnesemia, the standard antidote administered is intravenous calcium. Calcium directly antagonizes the neuromuscular effects of magnesium.

Evaluate the given options

• Magnesium gluconate: This is a magnesium supplement and would worsen hypermagnesemia.
• Cinacalcet: This is a calcimimetic used to treat hyperparathyroidism and does not treat acute hypermagnesemia.
• Calcium gluconate: This provides calcium ions to antagonize the cardiotoxic and neuromuscular effects of high magnesium levels.
• Regular insulin: This is used to treat hyperkalemia (high potassium), not hypermagnesemia.

Answer:

• (A) Magnesium gluconate
• (B) Cinacalcet
• (C) Calcium gluconate (Correct answer)
• (D) Regular insulin