A patient with renal insufficiency develops lethargy and somnolence with a blood pressure of 100/60, pulse 62, and respirations 10. The nurse notes that the patient has been taking an aluminum hydroxide/magnesium hydroxide suspension (Maalox) for indigestion. The nurse anticipates that management of the patient will include IV administration of

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The patient has a history and symptoms consistent with hypermagnesemia, so calcium gluconate or calcium chloride will be the initial therapy to oppose the effects of excess magnesium on cell function. Magnesium sulfate infusion is contraindicated because it will increase the serum magnesium level. Potassium chloride and sodium chloride will not impact the patient's symptoms and should be avoided in a patient with renal insufficiency.

A Patient with Renal Insufficiency Develops Lethargy and Somnolence with a Blood