1. 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

2. 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!

3. (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)

4. 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

5. 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

6. 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

7. 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!

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

9. 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

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

11. 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