COMMON CLINICAL SIGNS OBSERVED IN INFANTS WITH MODERATE TO SEVERE HYPERMAGNESEMIA INCLUDE ALL OF THE FOLLOWING, EXCEPT

A. Hypotonia
B. Delayed passage of stools
C. Jitteriness ✓
D. Respiratory depression

Hypermagnesemia is a condition characterized by an elevated level of magnesium in the blood. This mineral plays a crucial role in various bodily functions, including muscle and nerve function, heart rhythm, and blood pressure regulation. However, excessive magnesium levels can lead to adverse effects, particularly in infants.

Infants with moderate to severe hypermagnesemia may exhibit several clinical signs. These include:

Hypotonia: This refers to decreased muscle tone and weakness, which can result in poor reflexes and floppy limbs.
Delayed passage of stools: Hypermagnesemia can slow down gastrointestinal motility, leading to constipation and difficulty passing stools.
Respiratory depression: Excessive magnesium levels can depress the respiratory center in the brainstem, leading to shallow or slowed breathing or even apnea (cessation of breathing).

However, jitteriness is not a common clinical sign observed in infants with moderate to severe hypermagnesemia. Jitteriness is typically associated with conditions such as hypocalcemia or hypoglycemia, which cause increased neuronal excitability and result in tremors or involuntary muscle jerks. In contrast, hypermagnesemia tends to produce a sedating effect on the nervous system due to its ability to block voltage-gated calcium channels and enhance the action of inhibitory neurotransmitters like gamma-aminobutyric acid (GABA). Therefore, jitteriness is not an expected symptom of hypermagnesemia in infants.