Phosphate & Magnesium
Dina Barnes
Amanda Courtney
Olivia Fox
Jenna Batey
Nadine Bennett
Aileen Canaria
Emma Cunningham
Sara DeRosier
Alice Evered
Jessica Morr
Karen Robinson
Hannah Welfringer
Your friend phosphate and YOU
HINTS FOR IMBALANCE CAUSES:
It helps regulate cellular pH by
acting as a buffer!
You need it to make ATP.
Adenosine triPHOSPHATE! Hey!
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.
Hypophosphatemia
Causes:
< 2.5
mg/dl
Vitamin D deficiency
Antacid use
Long-term alcohol abuse
Malabsorption
syndromes
Respiratory alkalosis
Hyperparathyroidism
(increased renal
excretion of phosphate)
Hypophosphatemia symptoms:
Rad
Nurses
Check
Red
Blood
Cell
Count
In
Lethargic
Malnourished
Clients
Respiratory failure
How to correct it:
• Eat more phosphorus &
Numbness
vitamin D
Confusion
• Vitamin D supplements
Reduced oxygen transport
• Treat hyperparathyroidism
• If levels are critically low:
Bone resorption
IV phosphate
Cardiomyopathies
Convulsions
Nursing implications:
• Monitor WBC, RBC &
Irritability
platelets
Leukocyte/platelet dysfunction • Monitor nutritional status
for signs of malabsorption
Muscle/nerve dysfunction
• Monitor oxygen saturation
Coma
• Assess mental status
Mnemonic by Jenna Batey
Hyperphosphatemia
Causes:
Acute or chronic renal failure
Long-term use of enemas and
laxatives containing phosphates
Chemotherapy that releases
phosphate into the blood
Hypoparathyroidism
> 5.0
mg/dl
Hyperphosphatemia symptoms:
How to correct it:
Tweaking
Calcium
Tetany
Calcification (of soft tissues
Can
Clear
High
Convulsions
Cardiac arrest
Hyperneuromuscular
in lungs, kidneys, and joints)
activity
Phosphate Prolonged QT interval
Mnemonic by Jenna Batey
• 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
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
< 1.8
mg/dl
Causes:
Malnutrition
Alcoholism
Malabsorption
Urinary losses
(renal tubular dysfunction,
loop diuretics)
Hypomagnesemia symptoms:
Intelligent
Nurses
Infuse
Magnesium
Before
Heart
Arrhythmias
Turn
To
Cardiac arrest!
Irritability
Nystagmus
Increased reflexes
Muscle cramps
Behavioral changes
Hypotension
Ataxia
Tachycardia
Tetany
Convulsions
Mnemonic by Dina Barnes
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
Hypermagnesemia
Causes:
Renal
insufficiency or
failure
[most common!]
Adrenal
insufficiency
> 3.0
mg/dl
Excessive use
of antacids
containing
magnesium
Hypermagnesemia symptoms:
How to correct it:
Maintenance
Saline
Helps
Bodies
Reach
Normal
Electrolyte
Levels
• IV calcium is a magnesium
Muscle weakness
antagonist
Skeletal muscle contraction • IV fluids to treat
hypotension
Hypotension
• Enhance renal excretion
through saline diuresis
Bradycardia
Respiratory distress
Nursing implications:
• Strict I/Os
Nausea/vomiting
• Place patient on
Excess nerve function
continuous cardiac
Loss of deep tendon reflexes • monitoring
Watch for hypotension,
Mnemonic by Amanda Courtney
bradycardia, and
respiratory depression
• Assess neuromuscular
function and LOC