Magnesium Maggie — Magnesium Imbalance
Low Mg = torsades; high Mg = reflexes gone
Maggie is the electrolyte everyone forgets until the monitor twists into torsades. On one side of her story the reflexes are hyperactive; on the other they vanish completely.
Maggie swings both ways. Low magnesium (alcohol use, malnutrition, diuretics) causes tremors, hyperreflexia and torsades de pointes. High magnesium (renal failure, eclampsia infusions) wipes out reflexes and respirations — calcium gluconate is the antidote.
Read Magnesium Maggie's full story →The story arc
The setup
Years of heavy alcohol use and poor intake quietly drain Maggie's magnesium stores.
The turn
Her hands tremor, her reflexes are brisk, and her potassium refuses to come up despite repeated replacement.
The crisis
The monitor shows a QT that keeps stretching, then a twisting polymorphic rhythm.
The save
Magnesium sulfate is infused — and the nurse then watches reflexes, respirations and blood pressure for the opposite problem.
NCLEX study section — Magnesium Imbalance
What this chapter is testing: the recognition cues, the numbers and the priority action.
Study section: Endocrine & Metabolic
Take this chapter into practice questions on the same topic.