Fluid Electrolyte imbalance: Phosphorous
|
Phosphorous 2.5-4.5 mEq/dL Functions: Essential to tissue oxygenation, normal CNS function and movement of glucose into cells, assists in regulation of Calcium and maintenance of acid base balance Influenced by parathyroid hormone and has inverse relationship to Calcium. |
|
|
Hypophosphatemia |
|
|
Values: |
<2.5mEq/dL |
|
Causes: |
· Malnutrition · Hyperparathyroidism · Certain renal tubular defects · Metabolic acidosis · Disorders causing hypercalcemia
|
|
Signs and symptoms: |
· Impaired cardiac function · Poor tissue oxygenation · Muscle fatigue and weakness · N/V, anorexia · Disorientation, seizures, coma
|
|
Treatment: |
· Closely monitor and correct imbalances: - adequate amount of Phos - recommended dietary allowance for formula-fed infants 300 mg Phos/day for 1st 6 mos and 500 mg for latter ½ of first year - 1:1 ratio Phos and Ca recommended dietary allowance. Exception: infans whose calcium req’ts is 400 mg/day for 1st 6 mos and 500 mg for the next 6 months. · Treatment of moderate to severe deficiency: · Oral or IV phosphate (do not exceed rate of 10mEq/h) · Identify clients at risk for disorder and monitor · Prevent infections · Monitor levels during treatment |
|
Values: |
<2.5mEq/dL |
|
|
· Malnutrition · Hyperparathyroidism · Certain renal tubular defects · Metabolic acidosis · Disorders causing hypercalcemia
|
|
Hyperphosphatemia |
|
|
Values: |
>4.5mEq/dL |
|
Causes: |
· Chronic Renal failure (most common) · Hyperthyroidism · Hypoparathyroidism · Severe catabolic states · Conditions causing hypocalcemia |
|
Signs and symptoms: |
· Muscle cramping and weakness · ↑HR · Diarrhea · Abdominal cramping · Nausea
|
|
Treatment: |
· Goal: PREVENTION! · Restrict phosphate-containing food · Administer phosphate binding agents · Diuretics · Treat cause · Treatment may need to focus on correcting calcium levels |