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Phosphorus (PO₄)

BMP / Electrolytes
Normal range
3.0–4.5 mg/dL

SI: 0.97–1.45 mmol/L

Critical low: < 1 mg/dL · Critical high: > 8.9 mg/dL (context)

☎ When to call

Phos < 1.5 in a refeeding or ventilated patient — call; respiratory muscle failure is the risk.

What you do
  • Phos and calcium see-saw — high phos usually means low Ca symptoms to watch
  • Starting feeds on a malnourished patient? Watch phos daily — refeeding drops it fast
  • Severe low phos = weak respiratory muscles — watch work of breathing
Causes of HIGH phosphorus
Renal failureTumor lysis syndromeRhabdomyolysis
Causes of LOW phosphorus
Refeeding syndromeAlcohol use disorderDKA treatmentAntacid overuse
Source: Pagana, Mosby's Manual of Diagnostic and Laboratory Tests, 7th ed.Reference only — verify against your facility's policy.

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