Discharge And Home Healthcare Guidelines

PREVENTION. Teach the patient the importance of dietary and lifestyle changes. Refer the patient to a dietician if appropriate.

MEDICATIONS. Be sure the patient understands all medications, including the dosage, route, action, adverse effects, and the need for routine laboratory monitoring for lipid profiles.

COMPLICATIONS. Teach the patient to report to her or his physician the occurrence of signs and symptoms of CAD, such as chest pain, shortness of breath, and changes in mental status. Teach the patient the need for follow-up serum cholesterol and serum triglyceride tests. Instruct the patient to maintain a stable body weight and to adhere to any dietary restrictions before undergoing cholesterol tests. Most tests require the patient to fast for 12 hours before the test.

DRG Category: 296 Mean LOS: 5.4 days Description: MEDICAL: Nutritional and

Miscellaneous Metabolic Disorders, Age > 17 with CC

I I ypermagnesemia occurs when the serum magnesium concentration is greater than 2.7 mg/dL (2.3 mEq/L), but signs and symptoms do not occur until the magnesium reaches 4 mg/dL. The normal serum magnesium level is 1.7 to 2.7 mg/dL (1.4 to 2.3 mEq/L). Magnesium is found in the bones: 1% is located in the extracellular compartment, and the remainder is found within the cells.

Magnesium plays an important role in neuromuscular function. It also has a role in several enzyme systems, particularly the metabolism of carbohydrates and proteins, as well as maintenance of normal ionic balance (it triggers the sodium-potassium pump), osmotic pressure, myocardial functioning, and bone metabolism. Because the kidneys are able to excrete large amounts of magnesium (>5000 mg/day), either the patient has to ingest extraordinary amounts of magnesium or the glomerular filtration of the kidneys needs to be very depressed for the patient to develop hypermagnesemia. Complications include complete heart block, cardiac arrest, and respiratory paralysis.

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