Registered Nurse: Hypophosphatemia Flashcards Preview

NRSG 102: Med Surg 1 > Registered Nurse: Hypophosphatemia > Flashcards

Flashcards in Registered Nurse: Hypophosphatemia Deck (29)
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1
Q

Meaning of this?

A

Low levels of phosphate in the blood

2
Q

Normal Phosphate Levels?

A

2.7 - 4.5

3
Q

Level for this?

A

< 2.7

4
Q

Role of Phosphate in the body?

A

helps build bones/teeth and nerve/muscle function.

Stored mainly in the bones. The kidneys and parathyroid play a role in the regulation of calcium and phosphate.

5
Q

Calcium and Phosphate?

A

For example, when calcium levels increase in turn phosphate levels decrease (vice versa).

6
Q

Vitamin D and Phosphate

A

Vitamin D plays an important role in phosphate absorption.

7
Q

Saying for Causes of Hypophosphatemia

A

Low “Phosphate”

8
Q

“(P)hosphate”

A

Pharmacy: drugs such as aluminum hydroxide-based or magnesium based antacids cause malabsorption in the GI system, so no phosphate is absorbed through the GI track and the lack of vitamin d (which plays a role in phosphate absorption).

9
Q

“P(h)osphate”

A

Hyperparathyroidism: due to over secretion of parathyroid hormone (parathyroid plays a role in maintaining calcium and phosphate levels and it normally inhibits re-absorption of phosphate by the kidneys). However, in hyperparathyroidism there is an over secretion of PTH which causes phosphate to NOT be reabsorbed at all.

10
Q

“Ph(o)sphate”

A

Oncogenic osteomalacia: kidneys start to waste phosphate which leads to low phosphate levels and softening of the bones (this puts the patient at risk for bone fractures).

11
Q

“Pho(s)phate”

A

Syndrome of Refeeding (aka Refeeding Syndrome): causes electrolytes and fluid problems due to malnutrition or starvation.

12
Q

“Phos(p)hate”

A

Pulmonary issues such as respiratory alkalosis (under alkalotic conditions phosphate moves out of the blood into the cell which causes phosphate blood levels to decrease)

13
Q

“Phosp(h)ate”

A

Hyperglycemia leads to symptoms of glycosuria, polyuria, ketoacidosis which causes the kidneys to waste phosphate

14
Q

“Phosph(a)te”

A

Alcoholism: alcohol affects the body’s ability to absorb phosphate and many alcoholics are already malnourished (hence already have low phosphate level to begin with)

15
Q

“Phospha(t)e”

A

Thermal Burns due to the shifting of phosphate intracellularly

16
Q

“Phosphat(e)”

A

Electrolyte imbalances: hypercalcemia, hypomagnesemia, hypokalemia also cause phosphate levels to decrease

17
Q

Word for Signs and Symptoms of Hypophosphatemia

A

BROKEN

18
Q

(B)roken

A

Breathing problems due to muscle weakness

19
Q

B(r)oken

A

Rhabdomyolysis which is caused by an electrolyte disorder. This happens which there is rapid necrosis of the skeletal muscles which leads to renal failure. **These patients will have tea-colored looking urine due to myoglobin in the urine and will have muscle weakness/pain. The renal failure occurs because when the muscle dies, myoglobin is released into the blood which is very toxic to the kidneys. Reflexes (deep tendon) decreased

20
Q

Br(o)ken

A

Osteomalacia (softening of the bones) fractures and decreased bone density (alteration in bone shape), cardiac Output decreased

21
Q

Bro(k)en

A

Kills immune system with immune suppression and decreases platelet aggregation (which leads to increased bleeding)

22
Q

Brok(e)n

A

Extreme weakness, Ecchymoses from decreased platelets

23
Q

Broke(n)

A

Neuro status changes (irritability, confusion, seizures)

24
Q

What signs and symptoms should we look for

A

These patients are at risk for broken bones and the systems of the body are breaking down (respiratory, muscles, neuro, immune etc.)

25
Q

What should we administer?

A

**Administer oral phosphorus with Vitamin-D supplement (remember vitamin-d helps with absorbing phosphate)

26
Q

If patient is receiving TPN

A

TPN watch for patient complaints of muscle pain or weakness (may be due to rhabdomyolysis or refeeding syndrome)

27
Q

Safety due to

A

risk of bone fractures

28
Q

Encourage foods that are

A

high is phosphate but low in calcium: **Foods high in phosphate are fish, organ meats, nuts, pork, beef, chicken, whole grains

29
Q

What if Phosphate is less than 1?

A

the doctor may order IV phosphorous which affects calcium levels causing hypocalcemia or increase phosphate levels (Hyperphosphatemia). ***Also, assess renal status (BUN/creatintine normal) before administering phosphorous because if the kidneys are failing the patient won’t be able to clear phosphate). Place on cardiac monitor and watch for EKG changes.

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