CHPT 9 WATER Nutrition. Water Humans cant live but for a few days without water…10-14 days.
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Transcript of CHPT 9 WATER Nutrition. Water Humans cant live but for a few days without water…10-14 days.
CHPT 9 WATER
Nutrition
Water
bull Humans canrsquot live but for a few days without waterhellip10-14 days
Why is water important
bull It is the main component of all body cells
bull It makes up 50-60 of the body wt in normal adults
bull Men have more water wt due to the size of their muscles and muscle tissue
bull Newborns have the highest of H2O =75 of their body is water
Other functions of water
bull Solvent for nutrients and body wastesbull Aids in chemical reactionsbull Transports nutrients and wastes in bloodbull Needed for hydrolysis and digestionbull Lubricates jointsbull Regulated body temp by evaporation of
perspirationbull Serves as a shock absorber
bull Water content in muscle is greater than water content in fat
Body Water Content
Obese Normal Muscular 40 60 70
2 compartment of body water
bull 1 Intracellular ndash is the water within the cells itrsquos approx 65 of total body fluid
bull 2 Extracellular ndash is the water outside of the cells approx 35 of total body fluid
bull (includes intravascular amp interstitial fluid)
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Water
bull Humans canrsquot live but for a few days without waterhellip10-14 days
Why is water important
bull It is the main component of all body cells
bull It makes up 50-60 of the body wt in normal adults
bull Men have more water wt due to the size of their muscles and muscle tissue
bull Newborns have the highest of H2O =75 of their body is water
Other functions of water
bull Solvent for nutrients and body wastesbull Aids in chemical reactionsbull Transports nutrients and wastes in bloodbull Needed for hydrolysis and digestionbull Lubricates jointsbull Regulated body temp by evaporation of
perspirationbull Serves as a shock absorber
bull Water content in muscle is greater than water content in fat
Body Water Content
Obese Normal Muscular 40 60 70
2 compartment of body water
bull 1 Intracellular ndash is the water within the cells itrsquos approx 65 of total body fluid
bull 2 Extracellular ndash is the water outside of the cells approx 35 of total body fluid
bull (includes intravascular amp interstitial fluid)
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Why is water important
bull It is the main component of all body cells
bull It makes up 50-60 of the body wt in normal adults
bull Men have more water wt due to the size of their muscles and muscle tissue
bull Newborns have the highest of H2O =75 of their body is water
Other functions of water
bull Solvent for nutrients and body wastesbull Aids in chemical reactionsbull Transports nutrients and wastes in bloodbull Needed for hydrolysis and digestionbull Lubricates jointsbull Regulated body temp by evaporation of
perspirationbull Serves as a shock absorber
bull Water content in muscle is greater than water content in fat
Body Water Content
Obese Normal Muscular 40 60 70
2 compartment of body water
bull 1 Intracellular ndash is the water within the cells itrsquos approx 65 of total body fluid
bull 2 Extracellular ndash is the water outside of the cells approx 35 of total body fluid
bull (includes intravascular amp interstitial fluid)
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Other functions of water
bull Solvent for nutrients and body wastesbull Aids in chemical reactionsbull Transports nutrients and wastes in bloodbull Needed for hydrolysis and digestionbull Lubricates jointsbull Regulated body temp by evaporation of
perspirationbull Serves as a shock absorber
bull Water content in muscle is greater than water content in fat
Body Water Content
Obese Normal Muscular 40 60 70
2 compartment of body water
bull 1 Intracellular ndash is the water within the cells itrsquos approx 65 of total body fluid
bull 2 Extracellular ndash is the water outside of the cells approx 35 of total body fluid
bull (includes intravascular amp interstitial fluid)
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
bull Water content in muscle is greater than water content in fat
Body Water Content
Obese Normal Muscular 40 60 70
2 compartment of body water
bull 1 Intracellular ndash is the water within the cells itrsquos approx 65 of total body fluid
bull 2 Extracellular ndash is the water outside of the cells approx 35 of total body fluid
bull (includes intravascular amp interstitial fluid)
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Body Water Content
Obese Normal Muscular 40 60 70
2 compartment of body water
bull 1 Intracellular ndash is the water within the cells itrsquos approx 65 of total body fluid
bull 2 Extracellular ndash is the water outside of the cells approx 35 of total body fluid
bull (includes intravascular amp interstitial fluid)
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
2 compartment of body water
bull 1 Intracellular ndash is the water within the cells itrsquos approx 65 of total body fluid
bull 2 Extracellular ndash is the water outside of the cells approx 35 of total body fluid
bull (includes intravascular amp interstitial fluid)
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
What do these compartments mean
bull Intracellular ndash is inside the cell where K+ is found
bull Intravascular ndash inside the blood vessel
bull Interstitial ndash around the tissues
bull Extracellular ndash is both intravascular (inside of the blood vessel) AND interstitialhellipthis is where Na+ is found
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
bull How does the ldquopierdquo from the previous slide fit into the body exactly
bull TIP bull Water should always be in the 1st space firstbull Water should always be in the 2nd space second in
order for the normal body to function
bull And we try not to allow water to move to the 3rd space
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Cell = 1st spaceExtracellular (interstitial amp intravascular) = 2nd spaceAbdomen and feet = 3rd space (ascites)
1 cell
1 cell
2 extracellularinterstitial
2 bloodvessel(Intravascular)
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Best source of water
bull Is in drinking water
bull Beverages of all other types are 2nd best
bull Food contains water like fruits soups jello milk vegetables
bull Energy metabolism produces H20
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Estimated daily fluid intake for adults
bull Ingested liquids 1500ml
bull Water in foods 700ml
bull Water from oxidation 200mlraquo __________
bull TOTAL 2400ml
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
HOMEOSTASIS
bull Keeping the body = or at a balance
bull Our body has this mechanism related to fluids called
bull Fluid amp electrolyte balancebull This balance is for too little water (dehydration) or fluid
overload (too much water) in the bodyhellipboth can occur
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Fluid amp electrolyte balance
bull Water lost by healthy individuals through feces perspiration and the respiratory tract must be replaced in both volume and in electrolyte content
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Specific Gravity (SG)
bull This is a measurement of the weight of the particles in urine compared to the water in urine
bull If you have lots of particles = heavy urine=big number like 1020-1030
bull If you have diluted urine due to excess urination = light weight urine = low number like 1005-1010
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Urine Specific Gravity
bull Normal SG complete range-1005-1030bull Normal urine is 1010-1020bull This means that urine is straw yellow in
color and that the patient is urinating a minimum of 30mLhr
bull Small machine or test strip can tell you the SG of urine
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Equipment to test SG
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Vomiting amp Diarrhea
bull This type of illness where there is great water loss must be replaced quickly
bull IVFs in this case would be needed
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Symptoms of dehydration
bull Hypotension - (not enough fluid in the blood vessels to be pumped everywhere throughout your body)
bull Thirst
bull Eyes are sunken in
bull Mucus membranes are dry
bull Dry skindecreased skin turgor
bull Fever
bull Tachycardia
bull Mental disorientation
bull Specific gravity of lt1010 = clear
clear urine
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Treatment of this water loss
bull Replacement of the electrolytes and fluids
bull IVFs are a replacement if the amount lost is great
bull Drinking by mouth is preferred
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Sensible vs insensible loss
bull SENSIBLE LOSS ndash is noticeable loss of water as in urine losshellipnormal loss
bull INSENSIBLE LOSS ndash unnoticed water loss is in feces perspiration and respiration
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Normal daily water loss
bull The body must excrete 500ml of water as urine each day in order to get rid of the waste products of metabolism
bull This is 500 divided by 24 hrs= 208cchrbull + what we sweat and breathe off therefore
bull We should be excreting at least 30cchr minimum
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
DEHYDRATION amp OSMOSIS
bull Water moves through the cell walls by this mechanism
bull Remember water likes to dilute ldquostuffrdquo
bull Therefore water moves from an area with less stuff to an area with lots of stuff to dilute it
bull Where salt or protein ishellipwater follows
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
ELECTROLYTES
bull Na+
bull Cl-
bull K+
bull These electrolytes maintain the balance between intracellular and extracellular fluid
bull
bull Intravascular amp Interstitial
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Potassium K+
bull Is the principal electrolyte in INTRAcellular fluid
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Sodium Na+
bull Is the principal electrolyte in extracellular fluid
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Why we get thirsty
bull If the cell (1st space) becomes dehydrated as in the body lost water we become thirsty
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Why else can you become thirsty
bull When the electrolytes in the extracellular fluid are increased (hypertonic solution as in the
consumption of high sugar or salt) the intracellular fluid moves out of the cell to the extracellular fluid to try and dilute it or push the particles away from each other
bull This causeshellip
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Osmosis
bull The water from the inside of the cell (intracellular) to move out of the cell (osmosis) shrinking the cell = dehydration of the cell occurs
= thirst
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Is there any safety mechanism in the body to prevent this from
happening
bull YEShelliphellip 2 mechanisms try and prevent the body from getting dehydrated
bull 1) ADH
bull 2) Aldosterone
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
The hypothalamus saves the day
bull It is responsible for regulating appetite
and thirst
bull The hypothalamus
is located at the
base of the brain
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
During this timehellip
bull When the cell (1st space) releases all of its water to the extracellular fluid to try and separate those particles to dilute them the cell shrinks and the body says ldquought ohhhhrdquo
bull The hypothalamus sends a message to the pituitary gland to secrete ADH (antidiuretic hormone) when the electrolytes become too concentrated in the blood
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
PITUITARY GLAND
bull Known as the ldquoMaster Glandrdquobull It helps keep water in the blood via the kidneysbull It controls growth by sending growth hormonesbull It aids in releasing pitocin and sending breastmilk
out of the breastsbull It aids in reproduction by sending sex hormones
out to make a baby
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
ADH (anti-diuretic hormone)
bull By the hypothalamus sending the pituitary gland a message to excrete ADH the ADH goes to the kidney tubule and tells it to hold water and to reabsorb that water back into the bloodstream rather than to excrete it or urinate it out ADH is (against diuresis) anti-diuretic
bull If you didnrsquot have ADH then the water that was in the cells would now move out into the extracellular space to help dilute the high sugar or high salt you ate the cells become dehydrated then the kidney would pee out the water in the extracellular fluid and the body would be empty of waterhellipvery bad
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
What do you say when this process happens in the body
bull When the cell becomes empty of water because the ICF moved to the ECF to push particles apart your mouth and tongue know your cells are empty of water and your hypothalamus knows you are thirstyhellipso you say ldquoboy am I thirstyrdquo and you drink water
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
So what does ADH do for the body
bull When that ADH stops the water from leaving the renal tubule it can then be absorbed back into the blood and extracellular space and help push fluid and salts back into the bloodstream
bull It puts back just enough Na+ and K+ and that gets added to the water that wasnrsquot allowed to leave and it gets returned to circulation
bull Itrsquos the bodyrsquos way of getting its own drink of water from itself
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
2nd method of homeostasis our body has to prevent from dehydration
bull When you get dehydrated the hypothalamus sends a 2nd message to the pituitary to send a messenger known as ACTH (adrenocorticotropic hormone)
bull The pituitary sends the messenger ACTH to the adrenal glands that sit on the kidneys to wake up aldosterone
bull The hormone aldosterone ( a salt hormone) is sent out to help increase the Na+ reabsorption in the kidneys tubule and to send the salt to the blood stream so that nowhellipwhere there is extra Na+ water follows
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Hopefullyhellip
bull With the hormones ADH amp Aldosterone any dehydration can be fixed and the body will resume its normal pattern of having
bull fluid in the cells 1st
bull Fluid in the blood and interstitial area 2nd
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
What if another problem occurshellip
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
ADH gone wild (part I)
bull Heyyy-ooooo
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
bull There are times when the bodybrain cannot control ADH
bull If a patient has a tumor on the pituitary gland ADH may not be able to be made at allhellip
bull This is a serious condition and leads to serious results
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Fancy word for this conditionhellip
bull Diabetes Insipidous (DI)bull NOT DIABETES MELLITUS ndash inadequate production of insulin
causing difficulty in carbohydrate metabolism
bull Diabetes ndash a general term for diseases marked by excessive urination
bull DI ndash polyuria amp polydipsia caused by inadequate secretion of ADH from the pituitary
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Symptoms of darr ADH
bull Now itrsquos like all you have is DH = diuretic hormone = lots of urinehellipyou need the ldquoArdquo back
bull Polyuriabull Extreme thirstbull Extreme dehydration ldquoDehydrated Danrdquobull Hypotensionbull Tachycardiabull Tenting of skinbull Pt continues to urinate and urinate and urinatebull Specific gravity of lt1010can be as low as 1005
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Treatment for DI
bull To return the ldquoArdquo and give ADH to the body via a drug called vasopressin or Pitressin
bull Comes in a vial that pt can spray into nose
bull This helps concentrate urine again
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
ADH gone wild (part II)
bull What if you had a tumor to the pituitary gland and too much ADH was made
bull You would have too much against urination and you would hold fluidhellipyou would have ldquoagainst urinationrdquo
bull This disease is called SIADH = (uarrADH)bull Symptom of inappropriate ADHitrsquos
inappropriately madehellipitrsquos too much
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Aldosterone bull Any time the body has too much fluid on board it
spreads out the Na+ particles in the extracellular spaces Now the cell appears to be concentrated and the extracellular space looks diluted This triggers the nervous system to try and help
bull Hypothalamus calls to the pituitary to send ACTH to wake up the adrenals to send Aldosterone to the bloodstream
bull Because aldosterone is salt when salt reaches the bloodstream it will now appear that there are many particles in the extracellular space and now the normal cell moves some of its normal amt of water into the extracellular space to dilute the Na particles This now causes the cell to shrink and to re-balance things out
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Symptoms of SIADH
bull Too much fluid
bull Soggy and overloaded ldquoSoggy Sidrdquo
bull Extremely high HTN
bull Tachycardia
bull Specific gravity gt1020 more like 1030
bull Dark dark urine
bull Pt needs a fluid restriction
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Treatment of SIADH
bull Diuretics such as Lasix (furosemide)
bull Fluid restriction
bull Wt QD
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
How much water does the body need
bull The amt varies according to
bull activity heat and humidity age size and physical condition
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
bull We need 1ml for every calorie consumedbull If you eat 2100 calories in a day then you
need 2100ml water for that day
bull It is recommended that we drink 13 8ounce glasses of fluid day
bull This is 8 glasses of H20 and at least 5 glasses of other fluids
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
What increases your needs for water
bull Youth
bull Fever
bull Diarrhea
bull Unusual perspiration
bull Vomiting
bull Hemorrhage (loss of blood = loss of fluids)
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Another balancing mechanism - Acid Base Balance
bull Fluid and electrolyte balance are not the only things to be maintained in the bloodhellip
bull The body must maintain acid-base balance by using a buffer system
bull Your kidneys do this by regulating the hydrogen ions in the body (chemistry)
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
bull Acids and bases have + and ndash chargesbull All organs need these charges especially
the heart to workbull If they become unbalanced your body
knows it and fixes ithellipsends bicarb outbull Your kidneys are responsible to decide
which ions to keep and which to excrete out in the urine
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Normal ph
bull 7 is neutral
bull 1--------------7-------------14
bull acid neutral base
bull (acidic) (alkaline)
bull Blood plasma is 735-745
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Buffer system
bull Helps keep the acid-base balance in line
bull Example If too much HCL is removed from the body when vomiting your kidneys fix the body to balance out the now base solution
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Conditions that cause dehydration
bull Heat illness ndash caused by the excessive perspiration of body fluids with failure to drink sufficient amts of water to replace the lost
bull There are 4 stages of heat illnesshellip
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
4 stages of heat illness
bull Heat fatigue ndash causes thirst weakness fatigue one should go to a cool place rest and drink fluids
bull Heat cramp ndash dt loss of Na+ and K+ causes leg cramps and thirst one should go to a cool place rest and drink fluids
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
4 stages of heat illness
bull Heat exhaustion ndash causes thirst dizziness nv headache and profuse sweating one should get into a tub of cool water 2-3 days of rest and the ingestion of a great deal of water
bull Heat stroke ndash involves fever could produce brain and kidney damage call 911 put pt in chilled water and go to hospital Pt can die of heat stroke
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Excess water intake
bull Can be caused by
1 CHF heart pump isnrsquot working properly fluid gets all backed up
2 Hypoproteinemia (not enough protein water 3rd spaces to peritoneal cavity=big belly
3 Some infections4 Some cancers5 uarr ADH = SIADH Soggy Sid
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
In Reviewhellip
bull Our body is very smart
bull It knows how to balance out problems that occur with water
bull Osmosis hypothalamus pituitary ADH aldosterone and the kidneys is what balances the water in the body
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
Question
bull When one become dehydrated what happens to the concentration of the extracellular fluid compartment
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
QUESTION
bull When one can not eliminate fluid from the body but is still consuming more than enough water What happens to fluid in the extracellular fluid compartment
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
QUESTION
bull Water is lost or gained in what fluid compartment first
bull 2nd space then 1st space to protect the 1st space
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
QUESTION
bull What is fluid volume deficitbull What might cause a fluid volume deficitbull What happens to the concentration of
solute in the extracellular fluid compartment when one is lacking fluid or in a fluid volume deficit
bull What hormones tells the kidneys to conserve what ever water is left
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
What is this a picture of
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-
THE END
bull The need to replace body fluids is greaterbull than the need to replace electrolytesbull 1048714 Our thirst mechanism does not match ourbull hydration state so it is best to consumebull more fluid than thirst dictatesbull Replacing Fluid Lossesbull 1048714 Water intake during prolonged exercisebull reduces the risk of dehydration andbull optimizes performancebull 1048714 Drinking too much fluid can result inbull hyponatremia (low levels of plasmabull sodium) which can cause confusionbull disorientation and seizures
- CHPT 9 WATER
- Water
- Why is water important
- Other functions of water
- Slide 5
- Body Water Content Obese Normal Muscular 40 60 70
- Slide 7
- 2 compartment of body water
- What do these compartments mean
- Slide 10
- Slide 11
- Cell = 1st space Extracellular (interstitial amp intravascular) = 2nd space Abdomen and feet = 3rd space (ascites)
- Best source of water
- Estimated daily fluid intake for adults
- HOMEOSTASIS
- Fluid amp electrolyte balance
- Specific Gravity (SG)
- Urine Specific Gravity
- Equipment to test SG
- Vomiting amp Diarrhea
- Symptoms of dehydration
- Treatment of this water loss
- Sensible vs insensible loss
- Normal daily water loss
- DEHYDRATION amp OSMOSIS
- ELECTROLYTES
- Potassium K+
- Sodium Na+
- Why we get thirsty
- Why else can you become thirsty
- Osmosis
- Is there any safety mechanism in the body to prevent this from happening
- The hypothalamus saves the day
- During this timehellip
- PITUITARY GLAND
- ADH (anti-diuretic hormone)
- What do you say when this process happens in the body
- So what does ADH do for the body
- 2nd method of homeostasis our body has to prevent from dehydration
- Hopefullyhellip
- What if another problem occurshellip
- ADH gone wild (part I)
- Slide 43
- Fancy word for this conditionhellip
- Symptoms of darr ADH
- Treatment for DI
- ADH gone wild (part II)
- Aldosterone
- Symptoms of SIADH
- Treatment of SIADH
- How much water does the body need
- Slide 52
- What increases your needs for water
- Another balancing mechanism - Acid Base Balance
- Slide 55
- Normal ph
- Buffer system
- Conditions that cause dehydration
- 4 stages of heat illness
- Slide 60
- Excess water intake
- In Reviewhellip
- Question
- QUESTION
- Slide 65
- QUESTION
- What is this a picture of
- Slide 68
- THE END
-