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Ch8 Fluid Electrolyte_Balance

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  • Figure 8.1
  • Figure 8.3
  • Figure 8.6
  • Figure 8.8
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  • Table 8.1
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  • Figure 78.11
  • Figure 8.12
  • Figure 8.14

Transcript

  • 1. Chapter 8 Nutrients Involved with Fluid and Electrolyte Balance Lecture and Animation PowerPoint Copyright © The McGraw-Hill Companies, Inc. Permission required for reproduction or display. To run the animations you must be in Slideshow View . Use the buttons on the animation to play, pause, and turn audio/text on or off. Please Note : Once you have used any of the animation controls , you must click in the white background before advancing to the next slide.
  • 2. Fluid & Electrolyte Balance: Lecture Outline
    • Fluid
      • Intracellular vs. Extracellular Fluid
    • Electrolytes
      • Acid-Base Balance
    • Water
      • Functions
      • Balance
      • Intake & Output
      • Sources
    • Electrolyte Minerals
      • Sodium
      • Potassium
      • Chloride
    • Nutrition and Your Health
      • Minerals and Hypertension
  • 3. Fluid and Electrolyte Balance: Intracellular vs. Extracellular Fluid
    • Cell membranes are permeable
    • Intracellular Fluid:
      • Water found inside the cell
      • Accounts for 63% of body fluid
    • Extracellular Fluid:
      • Water outside the cell is located in either:
        • Fluid portion of blood (plasma) & lymph (7%) or
        • Interstitial fluid, the fluid between cells (30%)
  • 4. Fluid and Electrolyte Balance: Ion Concentration & Electrolytes
    • Ion concentration controls how much water is inside vs. outside of cells
    • Ions dissolve in water and are positively (+) or negatively (-) charged
    • Charged ions transfer electrical current and are called electrolytes
  • 5.
  • 6. Fluid and Electrolyte Balance: Electrolytes
    • The primary
    • extracellular ions are:
    • Sodium (Na + )
    • Chloride (Cl - )
    • The primary
    • intracellular ions are:
    • Potassium (K + )
    • Phosphate (PO 4 - )
  • 7. Osmosis
    • Passage of water from a low electrolyte concentration to an area of high electrolyte concentration
      • If solute concentration inside cell is greater than outside: water flows in, causing the cell to swell
      • If concentration outside cell is greater than inside: water flows out, causing the cell to shrink
  • 8.
  • 9. Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer.
  • 10. Electrolytes & Nerve Function
    • Electrolytes control nerve impulse conduction
    • All membranes can pump sodium (Na + ) from inside to outside the cell
    • When Na + is pumped out of the cell, K + enters to balance lose of + charged Na +
    • Inside of cell then has slight – charge
    • Difference in charge allows for nerve impulse transmission
  • 11. Electrolytes & Acid-Base Balance
    • Electrolytes help maintain pH balance
    • pH is determined by concentration of H + ions
    • Acids are produced as byproduct of nutrient metabolism
    • Acids must be neutralized to maintain pH
    • Normal extracellular pH: 7.4
  • 12. Electrolytes & Acid-Base Balance: Acidosis
    • Body accumulates too much acid -> acidosis
    • Acidosis = pH 7.0 – 7.3
    • Symptoms: disorientation & fatigue
    • Can occur in:
      • Poorly controlled diabetes
      • Starvation
      • Diarrhea
      • Excessive CO 2 production (ex: emphysema)
  • 13. Electrolytes & Acid-Base Balance: Alkalosis
    • When body loses too much acid -> alkalosis
    • Less often than acidosis, still critical
    • Alkalosis = pH 7.5 – 5.8
    • Symptoms: agitation & dizziness
    • Can occur in:
      • Diuretic use
      • Vomiting
      • Breathing off too much O 2 (ex: pneumonia or altitude sickness)
  • 14. Electrolytes & Acid-Base Balance: Buffers
    • Proteins are buffers: bind & release H + to control pH
    • Respiratory system is buffer: can ↑ or ↓ amount of CO2 exhaled during breathing
    • Electrolytes function in the kidneys to help buffer: they control release of acid & base in urine to maintain pH
  • 15.
  • 16. Some Words About Water…
    • H 2 O: 2 molecules of Hydrogen, 1 Oxygen
    • Most abundant molecule in your body
    • Your body can lose water through lungs, skin, urine and feces
    • Your body cannot store water
  • 17. Functions of Water
    • Universal solvent : where other substances can dissolve
    • Medium for chemical reactions
    • Waste removal
    • Lubricant for joints
    • Regulates body temperature
    • Major component of blood & maintains blood volume
  • 18. Functions of Water:
  • 19. Functions of Water: Temperature Regulation
    • When overheated:
      • Body perspires
      • Sweat evaporates through pores
      • Heat energy removed from skin
      • Body is cooled
  • 20. Functions of Water: Transports Nutrients
    • Transports nutrients to cells
    • Removes waste products from cells
  • 21. Functions of Water: Transports Nutrients
    • Protein
      • Protein breakdown produces H 2 O & CO 2
      • Nitrogen part of protein can ’t be used for energy – has to be excreted as urea
      • ↑ protein intake requires ↑ water intake
    • Sodium
      • ↑ sodium consumption = ↑ sodium excretion in urine
    • Amount of urine produced is determined primarily by excess protein & sodium
  • 22. Functions of Water: Urine Production
    • Typical urine production: 1 liter
    • Less than 500 ml (2 cups) = concentrated urine & ↑ work by kidneys
    • Best way to determine adequacy of fluid intake is to observe urine color:
      • Clear or light yellow is good hydration
      • Dark yellow and pungent is poor hydration
  • 23. Functions of Water: Urine Production
  • 24. Functions of Water: Lubricant
    • Water-based lubricants include:
      • Saliva : helps food pass from esophagus -> stomach
      • Mucus : protective coating through GI tract & lungs
      • Lubricating fluids in knees & other joints
      • Cerebral spinal fluid : spinal cord & brain
      • Amniotic fluid
  • 25. Water Balance
    • Muscle is 73% water
    • Adipose tissue is 10-20% water
    • Bone is approximately 20% water
    • Human body contains 50-70% water
    • As fat content ↑, % of lean tissue ↓ & total body water ↓
    • Extremely lean athletes = 70% body water
  • 26. Water Balance: Increased Fluid Needs
    • Athletes
    • Fever
    • Vomiting
    • Diarrhea
    • Older adults
    • Hot humid conditions
  • 27. Water Balance: Thirst
    • Controlled by your hypothalamus
    • Thirst is an indicator you are already dehydrated
    • Hypothalamus sensitivity ↓ with age = ↑ risk for dehydration in elderly
  • 28. Water Balance: Hormones
    • Antidiuretic hormone (ADH)
      • Secreted by pituitary gland when blood volume is ↓
      • Tells kidneys to ↓ water excretion which in turn ↑ blood volume
    • Aldosterone
      • Produced by adrenal glands
      • Tells kidneys to conserve sodium & water
  • 29. Water Balance: Dehydration
    • 1-2% body water loss -> feeling of thirst
    • 4% loss -> tired, dizzy, headache
    • 10% loss -> heat tolerance ↓ & weakness
    • Dehydration leads to:
      • Kidney failure
      • Coma
      • Death
  • 30. Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer.
  • 31. Water Intake
    • Water AI for women:
      • 2.7 liters/day (11 cups)
    • Water AI for men:
      • 3.7 liters/day (15 cups)
    • Water comes from food & water
      • Fluid needs for women are therefore:
        • 2.2 liters (9 cups)
      • Fluid needs for men are therefore:
        • 3 liters (13 cups)
  • 32. Water Intake: Water Content of Foods
  • 33. Please note that due to differing operating systems, some animations will not appear until the presentation is viewed in Presentation Mode (Slide Show view). You may see blank slides in the “Normal” or “Slide Sorter” views. All animations will appear after viewing in Presentation Mode and playing each animation. Most animations will require the latest version of the Flash Player, which is available at http://get.adobe.com/flashplayer.
  • 34. Water Loss
    • Through skin as perspiration
    • From lungs
    • Small amount lost in feces
  • 35. Water Balance
  • 36. Sources of Water
    • EPA regulates public water supplies
    • FDA regulates bottled water
    • Safety:
      • bottled water and tap water are similar in safety
      • bottled water is processed from tap water
      • bottled water does not contain fluoride
  • 37. Electrolytes
    • Sodium
    • Potassium
    • Chloride
  • 38. Sodium (Na + )
    • Table salt = sodium chloride = NaCl
      • 40% sodium
      • 60% chloride
    • 1 tsp of salt = 2,400 mg sodium
  • 39. Sodium (Na + ): Functions
    • Adds flavor to foods
    • Preserves food
    • Helps maintain fluid balance
    • Helps nerve impulse conduction
    • Helps absorption of some nutrients (ex: glucose)
  • 40. Sodium (Na + ): Deficiency
    • Groups at risk:
      • Low sodium diet
      • Excessive sweating (ex: athletes)
      • Persistent vomiting or diarrhea
    • Symptoms:
      • Muscle cramps
      • Nausea and vomiting
      • Dizziness
      • Shock
      • Coma
  • 41. Sodium (Na + ): Excess
    • ↑ urine output & can lead to dehydration
    • ↑ blood pressure
    • UL:
      • 2,300 mg/day
  • 42. Sodium (Na + ): Nutrient Needs
    • DRI:
      • For adults under age 51: 1,300 mg/day
      • For adults aged 51-70: 1,300 mg/day
      • For adults aged 71+: 1,200 mg/day
    • Average American consumption:
      • 2,300-4,700 mg/day
    • DV on food labels based on:
      • 2,400 mg/day
    • To lower blood pressure:
      • 2,000 mg/day or less
  • 43. Sodium (Na + ): Sources
    • High sodium foods:
      • Packaged foods
      • Processed foods
      • Fast food
      • Canned foods
      • Frozen, ready prepared foods (ex: pizza)
    • Low sodium foods:
      • Fruits & vegetables
      • Whole grains
      • Meats w/o sauces
      • Unprocessed foods
  • 44.
  • 45. Potassium (K): Functions
    • Water Balance
    • Nerve impulse transmission
    • Principal positively charged intracellular ion
    • ↑ potassium intake can help ↓ BP
  • 46. Potassium (K): Deficiency
    • Can be caused from:
      • Chronic diarrhea
      • Vomiting
      • Laxative abuse
      • Alcohol abuse
      • Eating disorders
      • Very low calorie diets
    • Symptoms include:
      • Loss of appetite
      • Muscle cramps
      • Confusion
      • Constipation
      • Irregular heart beat
  • 47. Potassium (K): Excess
    • Typical food intakes do not lead to potassium toxicity in people with healthy kidneys
    • If kidney function is poor: potassium builds up in blood, inhibits heart function & ↓ heartbeat
    • No Upper Level (UL) has been set
  • 48. Potassium (K): Nutrient Needs
    • AI for adults:
      • 4,700 mg
    • DV used on food labels:
      • 3,500 mg
    • Typical North American consumption:
      • 2,000-3,000 mg/day
  • 49. Potassium (K): Sources
    • Unprocessed foods
      • Fruits
      • Vegetables
      • Milk
      • Whole grains
      • Dried beans
      • meats
    • Major contributors in the diet include:
      • Milk
      • Potatoes
      • Beef
      • Coffee
      • Tomatoes
      • Orange juice
  • 50.
  • 51. Chloride (Cl - ) : Functions
    • Primary negatively charged ion in the extracellular fluid
    • Functions:
      • Component of stomach acid (HCl)
      • Immune response
      • Nerve function
  • 52. Chloride (Cl - ) : Deficiency
    • Prolonged vomiting (ex: bulimia or severe flu) can lead to acid-base disturbance due to large loss of stomach acid
    • Deficiency is unlikely because dietary salt intake is so high
  • 53. Chloride (Cl - ) : Excess
    • Plays a role in salt in raising blood pressure
    • UL is 3,600 mg/day
    • Because of ↑ salt intake, average North American intake of chloride is also ↑
  • 54. Chloride (Cl - ) : Nutrient Needs
    • AI for chloride is 2,300 mg/day
    • Based on 40:60 ratio of sodium: chloride in salt: (1,500 mg sodium: 2,300 mg chloride)
    • DV used on food labels is 5,400 mg
  • 55. Chloride (Cl - ) : Sources
    • Fruits & Vegetables
    • Chlorinated water
    • Salt (NaCl)
  • 56. Nutrition and Your Health: Minerals and Hypertension
    • Elevations in blood pressure are strong predictors of cardiovascular disease
    • 1 in 5 North Americans est. to have HTN
    • 1 in 2 North Americans > 65 y.o. have HTN
    • Often called “silent disease” – symptoms are not overt
  • 57. Blood Pressure Readings
    • Systolic blood pressure:
      • First of two numbers (the higher number)
      • BP in arteries when heart is contracting & pumping blood into arteries
      • Optimal: 120 mm Hg or less
    • Diastolic blood pressure:
      • Second of two numbers (the bottom, lower number)
      • BP in arteries when heart is relaxed
      • Optimal: 80 mm Hg or less
  • 58. Blood Pressure Readings
  • 59. Benefits of Controlling BP
    • ↓ cardiovascular disease risk
    • ↓ kidney disease risk
    • ↓ risk of stroke
    • Prevent poor brain function
    • Prevent poor blood circulation in legs
    • Prevent vision problems
    • Prevent sudden death
  • 60. HTN: What Increases Risk?
    • Smoking
    • Elevated blood lipoproteins
    • African American & Asian Americans have higher risk than do Caucasians
  • 61. Risk Factors for HTN
    • Family History
    • Age
    • Heart Disease
    • Overweight
    • Inactivity
    • Excess alcohol
    • High sodium intake
  • 62. What Dietary Factors are Related to HTN & HTN Risk?
    • ↓ risk of HTN & ↓ BP in people with HTN:
      • Calcium
      • Potassium
      • Magnesium
    • ↑ risk of HTN & ↑ BP in people with HTN:
      • Sodium
      • Excessive alcohol
  • 63. DASH Diet
    • Dietary Approach to Stop Hypertension
    • Diet is ↑ in: calcium, potassium, magnesium
    • Diet is ↓ in salt
    • Very high in fruits & vegetables (naturally ↓-salt, ↑-potassium foods)
  • 64. DASH Diet
  • 65. How to Lower BP