1. Hypophosphatemia

2. Description
• Hypophophatemia:
• Is a serum phosphorus level lower than 2.7
mg/dL
• A decrease in the serum phosphorus level is
accompanied by an increase in the serum
calcium

3. Causes
• Insufficient phosphorus intake: malnutrition and
starvation
• Increased phosphorus excretion
– Hyperparathyroidism
– Malignancy
– Use of aluminum hydroxide-based or magnesium
based antacids
• Intracellular shift
– Hyperglycemia
– Respiratory alkalosis

4. Assessment
• Cardiovascular
– Decreased contractility and cardiac output
– Slowed peripheral pulses
• Respiratory: shallow respirations
• Neuromuscular
– Weakness
– Decreased deep tendon reflexes
– Decreased bone density that can cause fractures and alterations in bone
shape
– Rhabdomyolysis
• Central Nervous System
– Irritability
– Confusion
– Seizures
• Hematological
– Decreased platelet aggregation and increased bleeding
– Immunosuppression

5. Interventions
• 2.7 – 4.5
• Monitor cardiovascular, respiratory, neuromuscular, CNS, &
hematological status
• Discontinue medications that contribute
• Administer phosphorus orally w/vitamin D supplement
• Prepare to administer phosphorus IV when serum levels fall below
1mg/dL and critical clinical manifestations
• Administer IV phosphorus slowly because of the risks associated
• Assess renal system before administering
• Move client carefully, & monitor for signs of a fracture
• Instruct client to increase intake of phosphorus containing foods
while decreasing intake of calcium containing foods
• Common Phosphorus Food Sources:
• Fish, organ meats, nuts, pork, beef, chicken, whole-grain breads and
cereals