The nurse is administering intravenous (IV) magnesium to a patient with hypomagnesemia. Which action should the nurse take to prevent the development of complications?

Question

A) Observe the cardiac telemetry monitor for ventricular arrhythmias.
B) Keep calcium gluconate on hand.
C) Infuse the IV magnesium slowly.
D) Administer loop diuretics.

Answer 1

C) Infuse the IV magnesium slowly.

Explanation: A) A danger of IV magnesium infusion is the development of hypermagnesemia. Cardiac arrhythmias associated with hypermagnesemia include bradyarrhythmias, tall T wave, widened QRS, prolonged QT interval, atrioventricular blocks, and finally, cardiac arrest. Ventricular tachycardia, ventricular fibrillation, and torsades de pointes may occur with hypomagnesemia. Observing the cardiac monitor, however, will not prevent complications.
B) Calcium gluconate should be kept on hand to treat hypermagnesemia stemming from overreplacement and/or rapid replacement. It does not, however, prevent complications during IV magnesium infusion.
C) Slow administration of intravenous magnesium reduces the risk of cardiac arrhythmias or conduction abnormalities such as heart blockade or asystole.
D) Loop diuretics with either sodium chloride or lactated Ringer's will help to promote excretion of magnesium in patients with hypermagnesemia and adequate renal function. It will not prevent complications of IV infusion of magnesium.