Download Most Common Electrolytes in the Human Body Fluids

Phosphorus (P3-)/Inorganic Phosphate (PO4)
Normal/Panic value
Other information
Phosphorus
(P3-)/
Inorganic
Phosphate (PO4)
Phosphorus is distributed
throughout the body in the
form of phosphate – 85% of
the body's phosphorus is
stored in the bones and the
rest in other cells of the
body – it's major roles are:
cellular metabolism,
particularly in the ATP
processes involved in
supplying the body with
energy
maintenance of cell
membranes
formation of bones and
teeth
release of oxygen from
hemoglobin
it is absorbed by the
intestines from dietary
sources and excreted
through the kidneys –
Vitamin D is necessary for
it's absorption from the GI
tract - must be replaced
through dietary consumption
- Phosphorus is regulated by
parathormone (PTH)
NOTE: an inverse
relationship exists between
phosphorus and calcium, so
high phosphate levels will
lower calcium levels in the
body and vice versa – a test
for serum phosphate
measures inorganic
phosphate in the blood –
most phosphorus in the
body is bound in organic
phosphate compounds
Normal adult:
2.5 – 4.5 (or 4.7)
mg/dl
0.8 – 1.4 mmol/liter
Normal urine in adult:
0.4 – 1.3 g/24 hrs
12.9 – 42.0 g/24 hrs
(SI units)
Panic (critical) values:
below 1 mg/dl
Foods high in
phosphorus:
milk, milk products,
poultry, fish, meat,
eggs, grains, legumes.
RefeedingSyndrome
(nutritional recovery
syndrom):
metabolic disturbances
that occur as a result
of reinstitution of
nutrition to patients
who are starved or
severely malnourished.
Patients develop fluid
and electrolyte
disorders, especially
hypophosphatemia,
along with neurologic,
pulmonary, cardiac,
neuromuscular and
hematologic
complicationsd due to
a sudden shift from fat
to carbohydrate
metabolism. It is due
to a decrease in
intracellular phosphate
stores. Some of the
types of patients at
risk for this: Anorexia
nervosa, Chronic
alcoholism, acute
salicylate poisoning, or
large areas of burns.
Hyperphosphatemia
The signs of
hyperphosphatemia are
nearly the same as for
hypocalcemia because of
the inverse relationship
that exists between these
two electrolytes:
Tingling in the tips of
the fingers
Tingling around the
mouth
Numbness in the limbs
Muscle spasms with
pain
Calcification of soft
tissues in lungs,
kidneys and joints
with prolonged
hyperphosphatemia
Tetany
Conditions causing
hyperphosphatemia
Acidosis
Acromegaly
Advanced lymphoma or
myeloma
Bone metastases
Chemotherapy for cancer
Diabetic ketoacidosis
Excessive levels of vitamin
D
Hemolytic anemia
Hyperthermia
Hypocalcemia
Hypoparathyroidism
Increased dietary or Iv
intake of phosphorus
Lactic acidosis
Liver disease with blood
clotting impairment
Long-term use of
phosphate-containing
enemas or laxatives
Milk alkali syndrome
Pseudohypoparathyroidism
Pulmonary embolism
Renal failure
Respiratory acidosis
Rhabdomyolysis
Sarcoidosis
Hypophosphatemia
Paresthesias
Muscle weakness such as
decreased hand grasps
and difficulty speaking
Tremors
Muscle pain and
tenderness
Apprehension
Confusion Delirium
Coma
Decreased cardiac
contractility
Acute respiratory failure
due to chest muscle
weakness
Seizures
Decreased tissue
oxygenation with
peripheral hypoxia (due
to disturbed energy
metabolism)
Reduced capacity for
oxygen transport by
RBCs
Conditions causing
hypophosphatemia
Acute gout
Alcohol withdrawal
Alkalosis
Chronic alcoholism
Chronic antacid ingestion
Diabetic acidosis
Gram-negative bacterial
septicemia
Growth hormone
deficiency
Hyperalimentation therapy
Hypercalcemia
Hyperinsulinism
Hyperparathyroidism
Hypokalemia
Impaired renal absorption
Inadequate dietary
ingestion of phosphorus
Malabsorption syndromes
Malnutrition
Osteomalacia
Parathyroid hormoneproducing tumors
Primary
hyperparathyroidism
Renal tubular acidosis
Renal tubular defects
Respiratory alkalosis
Respiratory infections
Rickets
Salicylate poisoning
Sepsis
Severe burns
Severe vomiting and
diarrhea
Vitamin D deficiency
results in inadequate
absorption of
phosphorus in the GI
tract
References: Fluid & Electrolyte Balance: Nursing Considerations, 4th edition, by Norma M. Metheny; Davis's Comprehensive Handbook of
Laboratory and Diagnostic Tests with Nursing Implications, 2nd edition, by Anne M. Van Leeuwen, Todd R. Kranpitz, and Lynette Smith;
Mosby's Diagnostic and Laboratory Test Reference, 4th edition, by Kathleen Deska Pagana and Timothy James Pagana; Nurse's 5-Minute
Clinical Consult: Diagnostic Tests, published by Wolter Kluwer/Lippincott Williams & Wilkins Health, 2008; Saunder's Comprehensive
Review for the NCLEX-RN Examination, 3rd edition, by Linda Anne Silvestri; Pathophysiology: The Biologic Basis for Disease in Adults and
Children, third edition, by Kathryn L. McCance and Sue E. Heuther; Pathophysiology: A 2-in-1 Reference for Nurses by Springhouse,
Springhouse Publishing Company Staff; Memory Notebook of Nursing, Volume II, 2nd edition, by JoAnn Zerwekh, Jo Carol Claborn, and C.J.
Miller