Page 254 - Saunders Comprehensive Review For NCLEX-RN

d. Rhabdomyolysis
4. Central nervous system
a. Irritability
b. Confusion
c. Seizures
5. Hematological
a. Decreased platelet aggregation and
increased bleeding
b. Immunosuppression
D. Interventions
1. Discontinue medications that contribute to
hypophosphatemia.

2. Administer phosphorus orally along with a

vitamin D supplement.
3. Prepare to administer phosphorus intravenously when
serum phosphorus levels fall below 1 mg/dL and
when the client experiences critical clinical
manifestations; administer IV phosphorus slowly
because of the risks associated with
hyperphosphatemia.

4. Assess the renal system before administering

phosphorus.

5. Move the client carefully, and monitor for

signs of a pathological fracture.
6. Instruct the client to increase the intake of the
phosphorus-containing foods while decreasing the
intake of any calcium-containing foods (see Box 11-2).

A decrease in the serum phosphorus level is accompanied by

an increase in the serum calcium level, and an increase in the serum
phosphorus level is accompanied by a decrease in the serum calcium
level. This is called a reciprocal relationship.
XIV. Hyperphosphatemia
A. Description
1. Hyperphosphatemia is a serum phosphorus level that
exceeds 4.5 mg/dL (1.45 mmol/L).
2. Most body systems tolerate elevated serum
phosphorus levels well.

3. An increase in the serum phosphorus level is

accompanied by a decrease in the serum calcium
level.
4. The problems that occur in hyperphosphatemia center

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