Water & the Minerals
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Transcript of Water & the Minerals
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Water & the Minerals
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Fluids Females 50-55% water Males 55-60% Less water in older adults More in children More in persons who
exercise
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Fluids Main functions
Shape and structure to cellsnormal turgor
Aids in digestion and absorption of nutrients
Transports/ lubricates Solvent/ chemical reactions Stabilizes body temperature
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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
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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
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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
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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
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Dehydration Fluid volume deficient or
hypovolemia Output exceeds water intake Shift of water from ECF to
ICF Lower blood volume Cellular edema
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Dehydration Hypovolemia symptoms
intense thirst dry mucous membranes weak and rapid pulse orthostatic hypotension vomiting and confusion concentrated urine life threatening -10% weight
loss
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Signs of dehydration
Headache/ lightheadness Fatigue Loss of appetite Flushed skin Heat intolerance Dry mouth and eyes Dark, scanty urine
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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
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Fluid overload Peripheral edema Rapid, bounding pulse Distended neck veins Pulmonary edema/SOB
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Fluids Adequate water intake 30 ml/kg or 1-1.5 ml/1
kcalorie energy expenditure Urine should be pale yellow
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Minerals
Inorganic elements Classified as macro and
trace elements by amount by need
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Functions Structure Fluid Balance Vitamin, enzyme, and
hormone activity Nerve cell transmission Muscle contraction
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Acid -Base balance Determined by pH Water regulates pH Normal pH 7.35-7.45 Acid base buffers
carbonic acid sodium bicarbonate
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Acid -Base Balance Disturbances
respiratory acidosischronic lung disease
metabolic acidosisketosis
respiratory alkalosishyperventalating
metabolic alkalosisvomiting
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Mineral salts NaCl in body water Movement directed by cells Water follows salt Separate into ions in
solution Conduct electricity Called electrolytes
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Electrolytes Cations-NA+, K+
Anions-Cl-
Usually balanced
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Sodium Principle electrolyte in ECF Primary regulator ECF volume Maintains acid base balance Muscular irritability Nerve impulse transmission Intestinal secretions 35-40% skeleton
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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
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Sodium Increased losses with
vomiting and diarrhea Replace both Na+ and water
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Potassium Principle cation in ICF Maintains cell integrity Keeps heart beat steady Deaths from severe diarrhea
or dieresis Assists in CHO and protein
metabolism
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Potassium High K foods associated
with decreased risk of stroke and lower blood pressure
Hypokalemia too low=death
Hyperkalemia too high =death
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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.
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Chloride Principle anion of ECF Not usually treated
separately from sodium problems
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Calcium Most abundant 99% bone and teeth 1% serum Bound with P04
-3 and Mg++
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Calcium Bones replete serum Serum Ca++
bone and teeth formation controls muscle contractions transmits nerve impulses blood clotting secretion of hormones
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Calcium Calcium Regulated very tightly 30-40% dietary calcium
absorbed bound to oxalates &
phytates in plant foods New recommendations
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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
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Calcium Deficiencies Means less bone density
Osteoporosis- thin, white or Asian women most at risk
Rickets- malabsorption of Ca++
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Calcium Deficiencies Sedentary lifestyle
less absorption Low calcium diet
increased blood pressure ETOH and smoking
increases losses
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Calcium Supplements Carbonate Citrate Acetate NO oyster shell
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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
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Calcium Excesses Constipation Kidney Stones
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Calcium Sources Milk Cheese Yogurt Soy & other legumes Whole grains Green Leafy Vegetables
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Phosphorous Combined with Ca++ in
bone and teeth 85% in bones Major body buffer Important in energy
transfers-ATP
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Phosphorous Absorption regulated by
parathyroid hormone Excesses excreted in urine Renal insufficiency =
high serum levels
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Phosphorous Deficiencies Malnutrition ETOH abuse Starvation
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Phosphorous Sources Meats Poultry Fish Eggs Legumes Milk and Dairy Products Soft drinks
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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
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Magnesium Deficiency Vomiting and diarrhea ETOH abuse Protein malnutrition Causes hallucinations in
ETOH withdrawal Prolonged muscle
contractions
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Magnesium Sources Green leafy vegetables Nuts Legumes Whole grains Seafood
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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
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Iron 10-15% dietary iron
absorbed Amount increases in
deficiency Nonheme Fe+++ ferric
plant source Nonheme and heme Fe++
ferrous animal source
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Iron Toxicity Repeated transfusions Polycystic disease Iron poisoning Symptoms
N&V shock convulsions and coma
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Iron Deficiencies Most deficient nutrient in US Nutritional Anemias Hemorrhagic Anemias Postgastrectomy anemia Malabsorption anemia Chronic disease anemia
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Iron Deficiencies Symptoms
weakness and fatigue headaches apathy
Pica-eating of non-nutrient substances ice, clay, paste, starch, kaolin
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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
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Iron Sources Liver Lean meat Dried beans Fortified cereals
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Iodine Major source is iodized salt Thyroid hormones
body temperature metabolic rate reproduction/growth nerve and muscle
functions
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Zinc Picked up by
albumin for transport Energy job Healing job Immune function
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Zinc Deficiencies Mental disorders Abnormal dark adaptation
in vision Skin lesions Hair loss Strict vegetarians at risk
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Iodine Deficiencies Goiter Weight gain Birth defects Cretinism
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Selenium Antioxidant Sparing effect on Vitamin C Research area Toxicity
hair & nail loss skin lesions diarrhea
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Selenium Rare deficiency in long
term parenteral nutrition
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Other Trace Minerals Copper
wound healing hemoglobin help cells use FE++
sheaths around nerve fibers Deficiency
dementia, liver failure
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Other Trace Minerals Manganese Fluoride
excess can mottle teeth Chromium
CHO/lipid metabolism works with insulin