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NRSG 102: Med Surg 1 > Exam 1: Phosphorus Imbalances > Flashcards

Exam 1: Phosphorus Imbalances Flashcards

1
Q

What does Phosphorus do?

A

Critical constituent of all body tissues. It is essential to the function of muscle and red blood cells; the formation of ATP, and 2-3 diphosphoglycerate which faciltates teh realse of oxygen from hemoglobin, and the maintenance of acid-base balance. AS well as intermeddiate metabolism of carbohydrate, protein, and fat

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2
Q

What structual suport does Phosphorus provide?

A

Provides structural support to bones and teeth.

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3
Q

Where is Phosphorus located?

A

85% in bones and teeth, 14% in soft tissue, and less than 1% in ECF

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4
Q

Normal Serum Phosphorus Level?

A

2.5-4.5 mg/dL

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5
Q

What does PTH do for Phosphorus?

A

Assists in phosphate homeostasis by varying phoshphate reabsorption in the proximal tubule of the kidney and allows the shift of phsophate from bone to plasma

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6
Q

Phosphorus Deficit name?

A

Hypophosphatemia

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7
Q

Phosphorus Excess Name?

A

Hyperphosphatemia

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8
Q

Hypophosphatemia Contributing Factors

A

Refeeding after starvation, alcohol withdrawal, diabetic ketoacidosis, respiratory and metabolic alkalosis, decreased magnesium, decreased potassium, vitamin d deficency,

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9
Q

Hypophosphatemia Signs/Symptoms

A

Paresthesias, Muscle Weakness, Bone Pain and Tenderness, Chest Pain, Confusion, Respiratory Failure, Seizures , Nystagmus

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10
Q

Hyperphosphatemia Contributing Factors

A

Acute kidney injury and chronic kidney disease, excessive intake of phosphorus, vitamin d excess, volume depletion

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11
Q

Hyperphosphatemia Signs/Symptoms

A

Tetancy, Tachycardia, Anorexia, Muscle Weakness, Hypocalcemia, N/V,

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12
Q

When might phosphorus deficiency occur?

A

When abnormally low content of phosphorus in lean tissues that may exist in the absence of Hyperphosphatemia. May be caused by an intracellular shift of potassium from serum into cells, by increased urinary excretion of potassiun, or decreased intestinal absorption of potassium

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13
Q

Hyperphosphatemia: Pathophysiology

A

May occur during administration of calories to patietns with severe protein-calorie malnutrition. More result of overzealous intake or administration of simple carbohydrates

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14
Q

Other causes of Hyperphosphatemia

A

Heat Stroke, Prolonged Intesnse Hyperventilation, Alcohol Withdrawal, poor Dietery Intake, Diabetic Ketoacidosis, REspiratory Alkalosis

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15
Q

What do Low magnsium levels, low potassium levels, and hyperparathyroidism related to urinary losses of phosphorus lead to?

A

Hyperphosphatemia

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16
Q

Hyperphosphatemia: Hypoxia

A

Leads to an increase in respiratory rate and respiratory alkalosis, causing phosphorus to move into the cells and potentiating Hyperphosphatemia

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17
Q

When testing, what could caught a decrease in serum phosphorus level?

A

Glucose or Insulin Administration causes a slight decrease in this.

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18
Q

PTH levels in Hyperparathyroidism?

A

They are increased

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19
Q

Serum Magnesium in Hypophosphatemia?

A

It may decrease due to increased urinary excretion of magnesium

20
Q

Hypophosphatemia: Medical Management

A

Patients at risk should have their serum phosphate levels closely monitored and correction initiated before deficits become severe

21
Q

Hypophosphatemia: Medical Management: IV

A

usually limited for the patient whose serum phosphorus levels decrease to less than 1 mg/dL and whose GI tract is not functioning

22
Q

Hypophosphatemia: Possible Effects from IV?

A

Tetany from Hypocalcemia and Calcifications in Tissues from Hyperphosphatemia.

23
Q

What foods should be given for those with mild Hyperphosphatemia

A

Milk and milk products, organ meats, nuts, fish, poultry, and whole grains

24
Q

Most common condition for Hyperphosphatemia

A

Kdiney injury .

25
Q

Other causes of Hyperphosphatemia

A

Increased intrake, decreased output, or a shift from the itnracellular to rextracellular space

26
Q

What other coniditions can lead to Hyperphosphatemia

A

Excessivce Vitamin D intake, administration of totral parenteral nutrition, chemotherapy, high phosphate intake, increased phosphorus.

27
Q

Primary complicaiton with increased phosphorus?

A

Metastatic Calcification, which occurs when the calcium - magnesium product exceeds 70 mg / dL

28
Q

High serum phosphorus levels tend to cause what for calcium?

A

Low serum calcium concentration

29
Q

Major long term consequence of Hyperphosphatemia?

A

Soft Tissue Calcification, which occurs mainly in patients with reduced glomerilar filtration rate.

30
Q

Phosphorus is the primary anion of what?

A

The ICF

31
Q

Hyphosphatemia: ATP deficiency impairs

A

cellular energy resources

32
Q

Hyphosphatemia: Diphosphoglycerate deficiency impairs

A

oxygen delivery to tissues, resulting in wide range of neurologic manifestations

33
Q

Hyphosphatemia: What may develop as ATP level in the muscle tissue declines?

A

Muscle damage.

34
Q

Hyphosphatemia: Clinical manifestations of muscle damage?

A

Muscle weakness, muscle pain, acute rhabdomyolysis. WEaknes of respiratory muscle greatly impair ventilation

35
Q

Hyphosphatemia: What is prescribed for those with moderate Hyphosphatemia

A

Neutra-Phos capsules
K-Phos
Fleet PhospoSoda

36
Q

Hyperphosphatemia: Most important short-term consequence is

A

tetany

37
Q

Hyperphosphatemia: What is useful for diagnosing the primary disorder?

A

Serum calcium level.

38
Q

Hyperphosphatemia: What test may show changes with abnormal bone development?

A

X-Ray

39
Q

Hyperphosphatemia: PTH level?

A

Decreased in hypoparathyroidism

40
Q

Hyperphosphatemia: BUN and Creatine levels are used to

A

assess renal function

41
Q

Hyperphosphatemia: MEedical Treatment . Hyperphosphatemia may be related to

A

volume depletion or respiratory or metabolic acidosis

42
Q

Hyperphosphatemia: MEdical management in kidney injury

A

Elevated PTH production contributes to high phosphorus level and bone disease

Measures to decrease and bind phosphorus to GI tract include Vitamin D prpeparation.

43
Q

Hyperphosphatemia: Medical Management with IV

A

IV administration of Calcitriol does not increase serum calcium. Thus calcium-binding antacids can be used

44
Q

Hyperphosphatemia: Medical Management - Restriction of

A

dietary phosphate, forced diuresis witha loop diruection , volume replace with saline,a and dialysis

45
Q

Hyperphosphatemia: Surgery indicated for

A

removal of calcium and phosphorus deposits

46
Q

Hyperphosphatemia: What foods should be avoided?

A 
Hard Cheese
Cream
Nuts
Meats
Whole-GRain Cereals
Dried Fruits/Veggies
Kidney
SArdines
Sweetbreads
Food made with milk

NRSG 102: Med Surg 1 (52 decks)

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