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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 cells normal turgor Aids in digestion and absorption of nutrients Transports/ lubricates

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Water & the Minerals

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  1. Water & the Minerals

  2. Fluids • Females 50-55% water • Males 55-60% • Less water in older adults • More in children • More in persons who exercise

  3. Fluids • Main functions • Shape and structure to cells • normal turgor • Aids in digestion and absorption of nutrients • Transports/ lubricates • Solvent/ chemical reactions • Stabilizes body temperature

  4. 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

  5. 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

  6. 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 Fluids

  7. Dehydration • Fluid volume deficient or hypovolemia • Output exceeds water intake • Shift of water from ECF to ICF • Lower blood volume • Cellular edema

  8. Dehydration • Hypovolemia symptoms • intense thirst • dry mucous membranes • weak and rapid pulse • orthostatic hypotension • vomiting and confusion • concentrated urine • life threatening -10% weight loss

  9. Signs of dehydration • Headache/ lightheadness • Fatigue • Loss of appetite • Flushed skin • Heat intolerance • Dry mouth and eyes • Dark, scanty urine

  10. 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

  11. Fluid overload • Peripheral edema • Rapid, bounding pulse • Distended neck veins • Pulmonary edema/SOB

  12. Fluids • Adequate water intake • 30 ml/kg or 1-1.5 ml/1 kcalorie energy expenditure • Urine should be pale yellow

  13. Minerals • Inorganic elements • Classified as macro and trace elements • by amount • by need

  14. Functions • Structure • Fluid Balance • Vitamin, enzyme, and hormone activity • Nerve cell transmission • Muscle contraction

  15. Acid -Base balance • Determined by pH • Water regulates pH • Normal pH 7.35-7.45 • Acid base buffers • carbonic acid • sodium bicarbonate

  16. Acid -Base Balance • Disturbances • respiratory acidosis • chronic lung disease • metabolic acidosis • ketosis • respiratory alkalosis • hyperventalating • metabolic alkalosis • vomiting

  17. Mineral salts • NaCl in body water • Movement directed by cells • Water follows salt • Separate into ions in solution • Conduct electricity • Called electrolytes

  18. Electrolytes • Cations-NA+, K+ • Anions-Cl- • Usually balanced

  19. Sodium • Principle electrolyte in ECF • Primary regulator ECF volume • Maintains acid base balance • Muscular irritability • Nerve impulse transmission • Intestinal secretions • 35-40% skeleton

  20. 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

  21. Sodium • Increased losses with vomiting and diarrhea • Replace both Na+ and water

  22. Potassium • Principle cation in ICF • Maintains cell integrity • Keeps heart beat steady • Deaths from severe diarrhea or dieresis • Assists in CHO and protein metabolism

  23. Potassium • High K foods associated with decreased risk of stroke and lower blood pressure • Hypokalemia • too low=death • Hyperkalemia • too high =death

  24. 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.

  25. Chloride • Principle anion of ECF • Not usually treated separately from sodium problems

  26. Calcium • Most abundant • 99% bone and teeth • 1% serum • Bound with P04-3 and Mg++

  27. Calcium • Bones replete serum • Serum Ca++ • bone and teeth formation • controls muscle contractions • transmits nerve impulses • blood clotting • secretion of hormones

  28. Calcium • Calcium • Regulated very tightly • 30-40% dietary calcium absorbed • bound to oxalates & phytates in plant foods • New recommendations

  29. 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

  30. Calcium Deficiencies • Means less bone density • Osteoporosis- thin, white or Asian women most at risk • Rickets- malabsorption of Ca++

  31. Calcium Deficiencies • Sedentary lifestyle • less absorption • Low calcium diet • increased blood pressure • ETOH and smoking increases losses

  32. Calcium Supplements • Carbonate • Citrate • Acetate • NO oyster shell

  33. 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

  34. Calcium Excesses • Constipation • Kidney Stones

  35. Calcium Sources • Milk • Cheese • Yogurt • Soy & other legumes • Whole grains • Green Leafy Vegetables

  36. Phosphorous • Combined with Ca++ in bone and teeth • 85% in bones • Major body buffer • Important in energy transfers-ATP

  37. Phosphorous • Absorption regulated by parathyroid hormone • Excesses excreted in urine • Renal insufficiency = high serum levels

  38. Phosphorous Deficiencies • Malnutrition • ETOH abuse • Starvation

  39. Phosphorous Sources • Meats • Poultry • Fish • Eggs • Legumes • Milk and Dairy Products • Soft drinks

  40. 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

  41. Magnesium Deficiency • Vomiting and diarrhea • ETOH abuse • Protein malnutrition • Causes hallucinations in ETOH withdrawal • Prolonged muscle contractions

  42. Magnesium Sources • Green leafy vegetables • Nuts • Legumes • Whole grains • Seafood

  43. 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

  44. Iron • 10-15% dietary iron absorbed • Amount increases in deficiency • Nonheme Fe+++ ferric • plant source • Nonheme and heme Fe++ ferrous • animal source

  45. Iron Toxicity • Repeated transfusions • Polycystic disease • Iron poisoning • Symptoms • N&V • shock • convulsions and coma

  46. Iron Deficiencies • Most deficient nutrient in US • Nutritional Anemias • Hemorrhagic Anemias • Postgastrectomy anemia • Malabsorption anemia • Chronic disease anemia

  47. Iron Deficiencies • Symptoms • weakness and fatigue • headaches • apathy • Pica-eating of non-nutrient substances • ice, clay, paste, starch, kaolin

  48. 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

  49. Iron Sources • Liver • Lean meat • Dried beans • Fortified cereals

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