N341 Phosphorus

Normal level

2.4-4.4

Where does phosphorus live

inside the cell

who is phosphorus neighbors with

potassium

Relationship with calcium

Inverse

Where is phosphorus absorbed

Gi tract

what delivers phosphorus

Vitamin D

Where does insulin move phosphorus

into the cell

What does acidosis do to phosphorus

moves phosphorus into the cell

What does alkalosis do to phosphorus

moves phosphorus out of the cell

foods that contain phosphorus

PHOSPHATE

Poultry

wHole Grains

Organ Meats

Seeds

Phish (Fish)

Hens (Eggs)

beAns

Tons of dairy

Everywhere!

phosphorus function

1. atp formation

2. O2 RBC -> tissue

3. Cell membrane integrity

4. metabolism carbs, fats, lipids

5. bones and teeth

6. neuro function

7. muscle function

True of False phosphate is a acid-base buffer

True

PTH hormone and phosphate

Increased PTH lowers phosphate levels by stimulating kidney elimination

hypophosphatemia level

< 2.4

Causes of hypophosphatemia

Decreased phosphate intake

Renal excretion

Acidosis

Decreased intestinal absorption (V/D, antacids, low VD)

Alcoholism

S/Sx of hypophosphatemia

Decreased ATP/Energy and O2 to CNS

Muscle weakness, malaise, anorexia

Paresthesia, slurred speech, confusion, seizures, coma

Decreased heart contractility

Respiratory failure

Rhabdomyolysis

Treatment of hypophosphatemia

Neutra-Phos

Diet

IV

Avoid antacids

Nursing interventions for hypophosphatemia

Assess neuro

Monitor IV rebound

Cardiac monitoring (can cause dysrhythmias)

Respiratory (can cause resp failure)

hyperphosphatemia levels

>4.4

Causes of hypophosphatemia

reduced excretion from kidneys

phosphate shifting from ICF to ECF (chemo, crush injury, rhabdo)

increases phosphate intake/absorption (laxative use, enemas)

medications that cause hyperphosphatemia

laxatives, enemas, chemo

S/Sx of hyperphosphatemia

Hypocalcemia S/Sx

CATSS Convulsions

Arrhythmias (OT prolongation)

Tetany (sustained muscle contraction)

Spasms and stridor

Signs (Chvosteks and Trousseau)

Treatment of hyperphosphatemia

diet and med restrictions

oral phosphate binders (calcium based salts, amphojel, sevelamer)

IV saline for renal excretion (must be functioning)

Nursing management for hyperphosphatemia

Monitor VS

Assess renal calculi

Assess for hypocalcemia

Education on laxatives and diets