Hypophosphatemia is a condition defined by a serum phosphorus level lower than 2.7 mg/dL, which can be caused by insufficient phosphorus intake, increased phosphorus excretion, or intracellular shifts. Symptoms include decreased cardiac and respiratory function, weakness, impaired reflexes, bone abnormalities, irritability, and bleeding issues. Treatment involves monitoring for symptoms, discontinuing contributing medications, supplementing with phosphorus and vitamin D orally or intravenously, careful movement to prevent fractures, and dietary adjustments to intake phosphorus-rich and limit calcium-rich foods.

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