Phosphate & Magnesium Dina Barnes Amanda Courtney Olivia Fox Jenna Batey Emma Cunningham Jessica Morr Nadine Bennett Sara DeRosier Karen Robinson Aileen Canaria Alice Evered Hannah Welfringer

Your friend phosphate and YOU HINTS FOR IMBALANCE CAUSES: You need vitamin D to take in phosphate!  Low phosphate is often related to malabsorption issues. Excess phosphate is cleared by the kidneys  High phosphate is often caused by renal failure. REMEMBER: Phosphate and calcium rise/fall in opposite ways! Both are regulated by PTH, so check for parathyroid issues. It helps regulate cellular pH by acting as a buffer! You need it to make ATP. Adenosine triPHOSPHATE! Hey!

(increased renal excretion of phosphate) Hypophosphatemia < 2.5 mg/dl Causes: Vitamin D deficiency Antacid use Long-term alcohol abuse Malabsorption syndromes Respiratory alkalosis Hyperparathyroidism (increased renal excretion of phosphate)

Hypophosphatemia symptoms: Rad Respiratory failure Nurses Numbness Check Confusion Red Reduced oxygen transport Blood Bone resorption Cell Cardiomyopathies Count Convulsions In Irritability Lethargic Leukocyte/platelet dysfunction Malnourished Muscle/nerve dysfunction Clients Coma How to correct it: Eat more phosphorus & vitamin D Vitamin D supplements Treat hyperparathyroidism If levels are critically low: IV phosphate Nursing implications: Monitor WBC, RBC & platelets Monitor nutritional status for signs of malabsorption Monitor oxygen saturation Assess mental status Mnemonic by Jenna Batey

Hyperphosphatemia Causes: > 5.0 mg/dl Acute or chronic renal failure Long-term use of enemas and laxatives containing phosphates Chemotherapy that releases phosphate into the blood Hypoparathyroidism

Hyperphosphatemia symptoms: How to correct it: Limit foods high in phosphate (dairy products, meats, nuts, etc.) Eat less process food Treat hypoparathyroidism Enhance renal excretion through saline diuresis Nursing implications: Diet is especially important for renal failure patients Be alert for signs of hypocalcemia (both lab values and symptoms) Place patient on continuous cardiac monitoring Tweaking Tetany Calcium Calcification (of soft tissues in lungs, kidneys, and joints) Can Convulsions Clear Cardiac arrest High Hyperneuromuscular activity Phosphate Prolonged QT interval Mnemonic by Jenna Batey

Your friend magnesium and YOU It’s a cofactor for a lot of enzymatic reactions in the cell! It interacts with potassium and calcium in reactions at the cellular level! It plays a role in smooth muscle contraction and relaxation!

Hypomagnesemia Causes: < 1.8 mg/dl Malnutrition Alcoholism Malabsorption Urinary losses (renal tubular dysfunction, loop diuretics)

Hypomagnesemia symptoms: How to correct it: Magnesium supplements Eat more magnesium-rich foods (spinach, legumes, whole grains, nuts, etc.) If levels are critically low: IV magnesium sulfate Nursing implications: Monitor nutritional status for signs of malabsorption Place patient on continuous cardiac monitoring Assess mental status Intelligent Irritability Nurses Nystagmus Infuse Increased reflexes Magnesium Muscle cramps Before Behavioral changes Heart Hypotension Arrhythmias Ataxia Turn Tachycardia To Tetany Cardiac arrest! Convulsions Mnemonic by Dina Barnes

Renal insufficiency or failure Hypermagnesemia > 3.0 mg/dl Causes: Adrenal insufficiency Excessive use of antacids containing magnesium Renal insufficiency or failure [most common!]

Hypermagnesemia symptoms: How to correct it: IV calcium is a magnesium antagonist IV fluids to treat hypotension Enhance renal excretion through saline diuresis Nursing implications: Strict I/Os Place patient on continuous cardiac monitoring Watch for hypotension, bradycardia, and respiratory depression Assess neuromuscular function and LOC Maintenance Muscle weakness Saline Skeletal muscle contraction Helps Hypotension Bodies Bradycardia Reach Respiratory distress Normal Nausea/vomiting Electrolyte Excess nerve function Levels Loss of deep tendon reflexes Mnemonic by Amanda Courtney