Transcript 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 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 Gastric Bile Pancreatic Intestinal TOTAL 1500 ml 2500 500 700 3000 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 acidosis chronic lung disease metabolic acidosis ketosis respiratory alkalosis hyperventalating metabolic alkalosis vomiting 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-ClUsually 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