Minerals by mikeholy

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									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              1500 ml
     Gastric             2500
     Bile                 500
     Pancreatic           700
     Intestinal          3000
      TOTAL              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                ICF
   water outside      water inside
    cell                cells
   1/3 body H20       2/3 body H20
   blood plasma       site of basic
   interstitial        metabolic
    fluids              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-Cl-
   Usually 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

								
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