PHRM 825: Fluids and Electrolytes - Electrolytes - PO4-

Question 1

Normal phosphorus blood level

Answer 1

2.5-4.5 mg/dL

Question 2

Phosphorus is critical for ________ including ______ function

Answer 2

Cellular structure and function; respiratory/cardiac muscle

Question 3

Phosphorus is important in enzymatic reactions that control ______

Answer 3

Carbohydrate, fat, and protein metabolism

Question 4

Phosphorus is the source of high-energy bonds in ___

Answer 4

ATP

Question 5

Phosphorus modulates the _____ of _____as 2,3-disphosphoglycerate

Answer 5

Oxygen carrying capacity of hemoglobin

Question 6

Phosphorus is regulated by what 4 things?

Answer 6

Intake, vitamin D, parathyroid hormone, and renal function

Question 7

Phosphorus concentration for mild to moderate hypophosphatemia

Answer 7

1-2 mg/dL

Question 8

Phosphorus concentration for severe hypophosphatemia

Answer 8

< 1 mg/dL

Question 9

Causes of hypophosphatemia

Answer 9

• Decreased intake
• Impaired absorption
• Intracellular shifts

Question 10

Neuro clinical presentation for hypophosphatemia

Answer 10

• Irritability
• Apprehension
• Weakness
• Numbness
• Paresthaesias
• Dysarthria
• Confusion
• Obtundation
• Seizures
• Coma
• Apathy
• Delirium
• Hallucinations
• Paranoia

Question 11

Clinical presentation for hypophosphatemia in the muscular system

Answer 11

• Myalgia
• Weakness
• Rhabdomyolysis
• Dysphagia
• Ileus

Question 12

Clinical presentation for hypophosphatemia in the blood

Answer 12

• Hemolysis
• WBC dysfunction
• Platelet dysfunction

Question 13

Clinical presentation for hypophosphatemia in the skeletal system

Answer 13

• Osteopenia
• Osteomalacia
• Bone pain

Question 14

Clinical presentation for hypophosphatemia in the cardiac system

Answer 14

• Cardiomyopathy
• Decreased contractility
• Arrhythmia

Question 15

Clinical presentation for hypophosphatemia in the renal system

Answer 15

ATN

Question 16

Clinical presentation for hypophosphatemia in the pulmonary system

Answer 16

• Acute respiratory failure
• Slow weaning from vent
• Respiratory muscle fatigue

Question 17

Treatment for mild to moderate hypophosphatemia

Answer 17

Oral PO4

Question 18

Oral PO4 meds

Answer 18

• Phos-NaK (10 mMol Phos/packet)

- Fleets Phospho-Soda (4.1 mMol/mL) 5 mL diluted

Question 19

Treatment for severe hypophosphatemia

Answer 19

IV PO4

Question 20

IV PO4 meds are available as ____ or ____

Answer 20

Potassium or sodium salts

Question 21

IV PO4 meds

Answer 21

• KPhos when K+ < 4 mEq/L

- NaPhos when K+ > or = 4 mEq/L

Question 22

Hypophosphatemia treatment guidelines

Answer 22

• Concentration 2.3-2.9 mg/dL: 0.32 mMol/kg
• Concentration 1.6-2.2 mg/dL: 0.64 mMol/kg
• Concentration <1.6 mg/dL: 1 mMol/kg

Question 23

1 mMol NaPhos = ____ mEq Na+ and Phos

Answer 23

1.33

Question 24

1 mMol KPhos = ____ mEq K+ and Phos

Answer 24

1.47

Question 25

Phosphorus administration

Answer 25

• Give PO as divided doses

- Infuse IV oses no more than 7 mMol/hr

Question 26

Causes of hyperphosphatemia

Answer 26

• Renal failure/insufficiency
• Hypoparathyroidism
• Excessive exogenous intake

Question 27

Clinical presentation of hyperphosphatemia

Answer 27

• Soft tissue calcifications

- Concurrent hypocalcemia

Question 28

When do soft tisue calcifications occur?

Answer 28

When Ca+2 and PO4- product >~60

Question 29

Treatment of

hyperphosphatemia

Answer 29

• IV calcium

- Decrease phosphate GI absorption

Question 30

When is treatment of hyperphosphatemia done?

Answer 30

When patients are severely symptomatic