Phosporus Flashcards
Primary anion found in
intracellular fluid
Normal serum levels (floss 1.8 times a day)
1.8-2.6mEq/L (or 3-4.5mg/dL)
85% phosphorus found in
bone & teeth
Combined in 1:2 ratio with
Ca++ 1, phosphate 2
14% found in (floss is soft)
1% found in
14% found in soft tissue
1% found in ECF
Plays a role in
cell membrane activity, muscle and neurological function
phosphate delivers 02 from what to what? (floss dragging blood to tissues)
O2 from RBCs to tissues
Buffers
acids and bases
Promotes energy transfer to
cells through ATP
Regulation - parathyroid?
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
Hypophosphatemia - intra or extracellular shifts? (too much phosphate shifting into cell)
Transient intracellular fluid shifts -
hypophosphatemia clinical manifestations (low flossssss makes tu sssssslur)
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.
hypophosphatemia -Diagnostic Tests - and what will be high? think inverse…
Serum phosphorus less than 1.7mEq/L (or less than 3mg/dL)
PTH will be elevated with hyperparathyroidism
Serum Ca++ will likely be increased
hypophosphatemia interventions (all the same, apical, I/O, heart, etc)
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
hyperphosphatemia - causes- (drowning in floss on the toilet) and what is the MAIN cause
Excessive intake of phosphates (laxative)
Extracellular fluid shifts (lactic acidosis)
Cellular destruction - crush injuries
Decreased urinary losses (renal failure MAIN cause of hyperphosphatemia**)
hyperphosphatemia - clinical manifestations - when floss is high, Ca is low…
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
hyperphosphatemia -Diagnostic tests - what numbers?
Diagnostic tests
Serum phosphorus greater than 2.6mEq/L (or 4.5mg/dL)
hyperphosphatemia - interventions (think coke and tums) and administer what re tums???
Administer phosphate binders as ordered - tums and alternagel
Administer stool softener - tums can constipate
hypophosphatemia - how does refeeding syndrome cause it?
causes surge insulin, pushes Phosphate into cells. need to make sure enough phosphate in parental solutions.
how does increased urine loss cause hypophosphatemia?
Increased urinary losses - loop diuretics promote loss, alcohol,
how does DKA cause hypophosphatemia? (d for decrease absorption)
DKA will promote
Decreased Intestinal Absorption, diarrhea
how does tissue injury cause hypophosphatemia? (floss heals my wounds)
Increased cellular use - healing phase of tissue injury Phosphate is needed.
hypophosphatemia causes (just urine basically)
Increased urinary losses
Decreased Intestinal Absorption,
Increased cellular use
hyperphosphatemia - tournacate - floss is cutting my cells
Be careful not to lyse cells - don’t keep tournacate on too tight
Serum Ca++ decreased
hyperphosphatemia - xray?
Xrays may see skeletal changes
hyperphosphatemia - blood work will show what? And what about PTH?
PTH level decreased
BUN and creatinine may help detect renal failure
hyperphosphatemia - Limit foods high in phosphorus ex.
soda, fish, red meat, milk, eggs, cheese
Monitor serum PO4- and Ca++ levels
hyperphosphatemia avoid what?
Avoid Vit D products - they increase phosphate and you don’t need more of it
hyperphosphatemia - monitor for what? (what is inverse with phosphate)
Monitor for signs of hypocalcemia
hyperphosphatemia - monitor what tests? (Bad kidneys have too much floss)
Monitor renal fx (BUN & Creatnine, U.O.) renal failure causes hyper - make sure kidneys aren’t failing.
phosphorus think…(floss wrapped around kidneys squeezes out phosphate)
kidneys. kidney failure causes hypophosphatemia
kidneys promote excretion of____and absorption of______(kidneys love to drink milk)
excretion - phosphorus
absorption - calcium
refeeding is and intra or extracellular shift?
an intracellular shift
main organ to think about with phosphate
kidneys
what do the kidneys do for phosphate, and what do they do for calcium? (Remember, they’re opposites)
phosphate - excrete
calcium - retain
