Hyperphosphatemia

Question 1

Normal level

Answer 1

2.7 to 4.5 mg

Question 2

Role

Answer 2

builds bone, teeth, nerve, muscle funtion
stored mostly in the bones
kidneys and PTH reg. phos
Calcium and phosphate influence each other in opp ways
Ex: increase in Ca+, decrease in Phos
Vit D plays a role in phos absorbtion

Question 3

Causes

Answer 3

PHOS HI
Reason - drug called phoslo that helps pts with ESRF keep phos down ( phospate binding drug
main reason for high phosphate is renal problems
Phospho- soda overuse: phosphate containing laxatives and enemas “ sodium phosphate/fleets enema) nerver give renal failure patients send them hyperphosphatemia
Hypoparathyroidism - decreased secretion of PTH ( maintains Ca+ and Phos. levels and normally inhibits phos reabsorbtion ( decreased PTH causes kidneys to keep too much phosphate)
Overuse of Vit D ( helps with absorbing phos)
Syndrome of tumor lysis occurs w/ chemo treatment of cancer… Cells die and release intracellular contents in the blood
rHabdomyolosis rapid necrosis of muscles dead muscles release myoglobin in blood toxic to kidney leads to renal failure
Infusufficiency of kidneys (ESRF) phos cannot be excreted

Question 4

S/S

Answer 4

Many same as hypocalcemia
Confusion
Reflexes hyperactive
Anorexia
Muscle spasms in calves, feet, tetany, seizures
Positive trousseaus signs
Sign of chevosteks
Calcium and phosphate opp relationship

Question 5

Nursing Intervention

Answer 5

admin phosphate binding drugs called phoslo
work on GI system puts phosphate in stool to be secreted
“ give with meals right after”
- no phosphate laxatives/enemas
- restrict food rich in phos- fish, nuts, chicken, beef, organ meats, pork, whole grains
-prepare pt. for dialysis