Ch8 Fluid Electrolyte_Balance Presentation 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 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 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 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

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 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