Medical Surgical Phosphate #2

Question

The nurse is caring for a client with hyperphosphatemia. Which items should the nurse instruct the client to avoid? Select all that apply.

Answers

  1. Organ meats
    • Rationale:

      This answer is correct because organ meat is a food source high in phosphorus. With hyperphosphatemia, the client should avoid foods high and rich in phosphorus.

  2. Amphojel
    • Rationale:

      This answer is not correct because amphojel is a medication used to reduce the serum phosphate level. This medication is used as one treatment for hyperphosphatemia.

  3. Vitamin C
    • Rationale:

      This answer is not correct because Vitamin C does not affect phosphorus. Vitamin C does not increase the client’s phosphorus level and actually helps the body fight to stay healthy.

  4. Whole grains
    • Rationale:

      This answer is correct because whole grains are food high in phosphorus. With hyperphosphatemia, the client needs to avoid foods high in phosphorus.

  5. Milk and milk products
    • Rationale:

      This answer is correct because milk and milk products are rich in phosphorus and should be avoided. Clients with hyperphosphatemia should avoid foods high in phosphorus.

Overview

Hyperphosphatemia is a serum phosphate level greater than 4.5 mg/dL. The client should avoid organ meats, whole grains, milk and milk products because all are high in phosphorus.

Explanation

Learning Outcomes

In hyperphosphatemia there is an abnormally high serum phosphate level. This condition is caused by chronic kidney disease, hypoparathyroidism, and both metabolic and respiratory acidosis. Clinical manifestations are often due to the accompanying low serum calcium levels (i.e., hypocalcemia) and include tetany. Amphojel interferes with medications used to reduce the serum phosphate level; therefore, the nurse instructs the client to avoid this item based on the current diagnosis. The client should avoid organ meats, whole grains, milk and milk products because all are high in phosphorus. There is no reason for the client to avoid vitamin C. Vitamin C helps increase the body’s immune system to fight off infections.

Test Taking Tip

Consider the impact that each item may have on the client’s diagnosis to correctly answer the question. Know the prefixes hyper- and hypo- and recognize the differences with each.

Video Rationale