Phosporus

Question 1

Primary anion found in

Answer 1

intracellular fluid

Question 2

Normal serum levels (floss 1.8 times a day)

Answer 2

1.8-2.6mEq/L (or 3-4.5mg/dL)

Question 3

85% phosphorus found in

Answer 3

bone & teeth

Question 4

Combined in 1:2 ratio with

Answer 4

Ca++ 1, phosphate 2

Question 5

14% found in (floss is soft)
1% found in

Answer 5

14% found in soft tissue
1% found in ECF

Question 6

Plays a role in

Answer 6

cell membrane activity, muscle and neurological function

Question 7

phosphate delivers 02 from what to what? (floss dragging blood to tissues)

Answer 7

O2 from RBCs to tissues

Question 8

Buffers

Answer 8

acids and bases

Question 9

Promotes energy transfer to

Answer 9

cells through ATP

Question 10

Regulation - parathyroid?

Answer 10

Dietary intake - meat, fish, milk
Intestinal absorption -via gi tract, promoted by vitamin D and Parathyroid hormone
Calcium Levels
promotes EXCRETION by Kidneys (does opposite with ca)
inverse relationship with Ca

Question 11

Hypophosphatemia - intra or extracellular shifts? (too much phosphate shifting into cell)

Answer 11

Transient intracellular fluid shifts -

Question 12

hypophosphatemia clinical manifestations (low flossssss makes tu sssssslur)

Answer 12

Sx may be acute or develop gradually
Majority of sx due to decreased ATP
higher Ca
mental status, slurred, seizures, muscle weakness, anemia, monitor for dysrthmias.

Question 13

hypophosphatemia -Diagnostic Tests - and what will be high? think inverse…

Answer 13

Serum phosphorus less than 1.7mEq/L (or less than 3mg/dL)
PTH will be elevated with hyperparathyroidism
Serum Ca++ will likely be increased

Question 14

hypophosphatemia interventions (all the same, apical, I/O, heart, etc)

Answer 14

Assess & document LOC, orientation, neurologic status with each VS
Assess muscle strength and deep tendon reflexes
Administer Phosphate as ordered
as - po or - IV. monitor IV carefully. must have good kidney function. monitor I/O before and after. Arrhytmias are possible so monitor apical HR.
Encourage intake of foods rich in phosphorus
Medicate for pain
Monitor for signs of cardiac or pulmonary complications

Question 15

hyperphosphatemia - causes- (drowning in floss on the toilet) and what is the MAIN cause

Answer 15

Excessive intake of phosphates (laxative)
Extracellular fluid shifts (lactic acidosis)
Cellular destruction - crush injuries
Decreased urinary losses (renal failure MAIN cause of hyperphosphatemia**)

Question 16

hyperphosphatemia - clinical manifestations - when floss is high, Ca is low…

Answer 16

most are asymtomatic
except for Sx of hypocalcemia.
Possible sx of renal failure
If chronic can lead to precipitate of calcium and phosphate deposits in soft tissues

Question 17

hyperphosphatemia -Diagnostic tests - what numbers?

Answer 17

Diagnostic tests
Serum phosphorus greater than 2.6mEq/L (or 4.5mg/dL)

Question 18

hyperphosphatemia - interventions (think coke and tums) and administer what re tums???

Answer 18

Administer phosphate binders as ordered - tums and alternagel
Administer stool softener - tums can constipate

Question 19

hypophosphatemia - how does refeeding syndrome cause it?

Answer 19

causes surge insulin, pushes Phosphate into cells. need to make sure enough phosphate in parental solutions.

Question 20

how does increased urine loss cause hypophosphatemia?

Answer 20

Increased urinary losses - loop diuretics promote loss, alcohol,

Question 21

how does DKA cause hypophosphatemia? (d for decrease absorption)

Answer 21

DKA will promote
Decreased Intestinal Absorption, diarrhea

Question 22

how does tissue injury cause hypophosphatemia? (floss heals my wounds)

Answer 22

Increased cellular use - healing phase of tissue injury Phosphate is needed.

Question 23

hypophosphatemia causes (just urine basically)

Answer 23

Increased urinary losses
Decreased Intestinal Absorption,
Increased cellular use

Question 24

hyperphosphatemia - tournacate - floss is cutting my cells

Answer 24

Be careful not to lyse cells - don’t keep tournacate on too tight
Serum Ca++ decreased

Question 25

hyperphosphatemia - xray?

Answer 25

Xrays may see skeletal changes

Question 26

hyperphosphatemia - blood work will show what? And what about PTH?

Answer 26

PTH level decreased
BUN and creatinine may help detect renal failure

Question 27

hyperphosphatemia - Limit foods high in phosphorus ex.

Answer 27

soda, fish, red meat, milk, eggs, cheese
Monitor serum PO4- and Ca++ levels

Question 28

hyperphosphatemia avoid what?

Answer 28

Avoid Vit D products - they increase phosphate and you don’t need more of it

Question 29

hyperphosphatemia - monitor for what? (what is inverse with phosphate)

Answer 29

Monitor for signs of hypocalcemia

Question 30

hyperphosphatemia - monitor what tests? (Bad kidneys have too much floss)

Answer 30

Monitor renal fx (BUN & Creatnine, U.O.) renal failure causes hyper - make sure kidneys aren’t failing.

Question 31

phosphorus think…(floss wrapped around kidneys squeezes out phosphate)

Answer 31

kidneys. kidney failure causes hypophosphatemia

Question 32

kidneys promote excretion of____and absorption of______(kidneys love to drink milk)

Answer 32

excretion - phosphorus
absorption - calcium

Question 33

refeeding is and intra or extracellular shift?

Answer 33

an intracellular shift

Question 34

main organ to think about with phosphate

Answer 34

kidneys

Question 35

what do the kidneys do for phosphate, and what do they do for calcium? (Remember, they’re opposites)

Answer 35

phosphate - excrete
calcium - retain