Discharge And Home Healthcare Guidelines

Encourage the patient to maintain a balance between dietary and pharmacologic calcium. Dietary calcium should be increased and phosphorus decreased. Fluid and fiber should be increased. Milk, milk products, meat, poultry, fish, egg yolks, and cereals, although high in calcium, should be limited because of their phosphorus content. Chocolate is known to interfere with calcium absorption.

Remind the patient to take medications exactly as prescribed and not to substitute over-the-counter medications for prescribed calcium. Vitamin D supplements are frequently prescribed as

498 Hypophosphatemia well, sometimes in large doses. The patient may take a phosphate binder before or after meals. Some patients may also be placed on thiazide diuretics to control serum calcium. Remind women of child-bearing age that pregnancy will significantly alter their calcium needs. Teach the patient about the disease process and the signs and symptoms of calcium imbalance. Stress which symptoms require immediate medical attention, and teach the patient the necessity of ongoing medical follow-up and the need to wear a Medic Alert bracelet.

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