Water & the Minerals
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Transcript of Water & the Minerals
Water & the Minerals
Fluids Females 50-55% water Males 55-60% Less water in older adults More in children More in persons who
exercise
Fluids Main functions
Shape and structure to cellsnormal turgor
Aids in digestion and absorption of nutrients
Transports/ lubricates Solvent/ chemical reactions Stabilizes body temperature
Fluids Adults metabolize 2.5-3
liters water/day Excrete 500-600 ml/day to
get rid of body wastes 7-9 liters secreted into GI
tract each day almost all reabsorbed
Approximate Total Volume of
Digestive Secretions Produced in 24
Hours by Adult of Average Size
Secretion Amount
Saliva 1500 mlGastric 2500Bile 500Pancreatic 700Intestinal 3000
TOTAL 8200 ml
Fluids Normal losses 2.5 liters/day Obligatory Facultative Thirst-not always accurate
diminished in elderly infants can’t tell you watch color of urine
Fluids ECF water outside
cell 1/3 body H20 blood plasma interstitial
fluids
ICF water inside
cells 2/3 body H20 site of basic
metabolic activity
Dehydration Fluid volume deficient or
hypovolemia Output exceeds water intake Shift of water from ECF to
ICF Lower blood volume Cellular edema
Dehydration Hypovolemia symptoms
intense thirst dry mucous membranes weak and rapid pulse orthostatic hypotension vomiting and confusion concentrated urine life threatening -10% weight
loss
Signs of dehydration
Headache/ lightheadness Fatigue Loss of appetite Flushed skin Heat intolerance Dry mouth and eyes Dark, scanty urine
Fluid overload Fluid volume excess or
hypervolemia Fluid intoxication
muscle cramps and low BP
excessive water intake renal failure or CHF water shifts from cell to ECF
Fluid overload Peripheral edema Rapid, bounding pulse Distended neck veins Pulmonary edema/SOB
Fluids Adequate water intake 30 ml/kg or 1-1.5 ml/1
kcalorie energy expenditure Urine should be pale yellow
Minerals
Inorganic elements Classified as macro and
trace elements by amount by need
Functions Structure Fluid Balance Vitamin, enzyme, and
hormone activity Nerve cell transmission Muscle contraction
Acid -Base balance Determined by pH Water regulates pH Normal pH 7.35-7.45 Acid base buffers
carbonic acid sodium bicarbonate
Acid -Base Balance Disturbances
respiratory acidosischronic lung disease
metabolic acidosisketosis
respiratory alkalosishyperventalating
metabolic alkalosisvomiting
Mineral salts NaCl in body water Movement directed by cells Water follows salt Separate into ions in
solution Conduct electricity Called electrolytes
Electrolytes Cations-NA+, K+
Anions-Cl-
Usually balanced
Sodium Principle electrolyte in ECF Primary regulator ECF volume Maintains acid base balance Muscular irritability Nerve impulse transmission Intestinal secretions 35-40% skeleton
Sodium 1 gram sodium in 1/5 t. of NaCl Salt is 39% sodium Use less with HTN, CHF, and
Kidney Failure Adjust depending on climate
and physical activity Suggested intake 2400 mg or
1000mg/1000 kcalories
Sodium Increased losses with
vomiting and diarrhea Replace both Na+ and water
Potassium Principle cation in ICF Maintains cell integrity Keeps heart beat steady Deaths from severe diarrhea
or dieresis Assists in CHO and protein
metabolism
Potassium High K foods associated
with decreased risk of stroke and lower blood pressure
Hypokalemia too low=death
Hyperkalemia too high =death
Lower Sodium Diet
Reduce sodium gradually Learn to read the food labels
and compare brands Fresh is best Balance high and low
sodium foods Experiment with herbs,etc.
Chloride Principle anion of ECF Not usually treated
separately from sodium problems
Calcium Most abundant 99% bone and teeth 1% serum Bound with P04
-3 and Mg++
Calcium Bones replete serum Serum Ca++
bone and teeth formation controls muscle contractions transmits nerve impulses blood clotting secretion of hormones
Calcium Calcium Regulated very tightly 30-40% dietary calcium
absorbed bound to oxalates &
phytates in plant foods New recommendations
Calcium Serum levels kept constant Vitamin D and parathyroid
hormone raises Ca++ levels PRN
Calcium travels with Albumin in blood-need to do corrected Ca++ calculation if Albumin low
Calcium Deficiencies Means less bone density
Osteoporosis- thin, white or Asian women most at risk
Rickets- malabsorption of Ca++
Calcium Deficiencies Sedentary lifestyle
less absorption Low calcium diet
increased blood pressure ETOH and smoking
increases losses
Calcium Supplements Carbonate Citrate Acetate NO oyster shell
Supplements
No more than 2500mg per day
Count amounts from food Smaller divided doses Do not take iron and
calcium at the same time Plenty of fluids
Calcium Excesses Constipation Kidney Stones
Calcium Sources Milk Cheese Yogurt Soy & other legumes Whole grains Green Leafy Vegetables
Phosphorous Combined with Ca++ in
bone and teeth 85% in bones Major body buffer Important in energy
transfers-ATP
Phosphorous Absorption regulated by
parathyroid hormone Excesses excreted in urine Renal insufficiency =
high serum levels
Phosphorous Deficiencies Malnutrition ETOH abuse Starvation
Phosphorous Sources Meats Poultry Fish Eggs Legumes Milk and Dairy Products Soft drinks
Magnesium Small amount in body Critical to operation of
hundreds of enzymes Smooth muscle relaxation Necessary for release of
energy Holds calcium in tooth
enamel
Magnesium Deficiency Vomiting and diarrhea ETOH abuse Protein malnutrition Causes hallucinations in
ETOH withdrawal Prolonged muscle
contractions
Magnesium Sources Green leafy vegetables Nuts Legumes Whole grains Seafood
Iron 3-5 g stored in body 2/3 as heme in hemoglobin 1/3 as ferritin RBC carries O2 to tissues Needed for new cells
Iron 10-15% dietary iron
absorbed Amount increases in
deficiency Nonheme Fe+++ ferric
plant source Nonheme and heme Fe++
ferrous animal source
Iron Toxicity Repeated transfusions Polycystic disease Iron poisoning Symptoms
N&V shock convulsions and coma
Iron Deficiencies Most deficient nutrient in US Nutritional Anemias Hemorrhagic Anemias Postgastrectomy anemia Malabsorption anemia Chronic disease anemia
Iron Deficiencies Symptoms
weakness and fatigue headaches apathy
Pica-eating of non-nutrient substances ice, clay, paste, starch, kaolin
Iron Deficiency Anemia Increase food sources
Include iron fortified cereals
Know heme iron sources Add sources of Vitamin C Drink coffee & tea between
meals, not with meals Cook in iron pots
Iron Sources Liver Lean meat Dried beans Fortified cereals
Iodine Major source is iodized salt Thyroid hormones
body temperature metabolic rate reproduction/growth nerve and muscle
functions
Zinc Picked up by
albumin for transport Energy job Healing job Immune function
Zinc Deficiencies Mental disorders Abnormal dark adaptation
in vision Skin lesions Hair loss Strict vegetarians at risk
Iodine Deficiencies Goiter Weight gain Birth defects Cretinism
Selenium Antioxidant Sparing effect on Vitamin C Research area Toxicity
hair & nail loss skin lesions diarrhea
Selenium Rare deficiency in long
term parenteral nutrition
Other Trace Minerals Copper
wound healing hemoglobin help cells use FE++
sheaths around nerve fibers Deficiency
dementia, liver failure
Other Trace Minerals Manganese Fluoride
excess can mottle teeth Chromium
CHO/lipid metabolism works with insulin