Nutrition and Diet Therapy Water Balance Chapter 9 – Flashcards
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Body Water Functions 4 Functions
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Solvent, Transport, Thermoregulation, Lubrication
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DRI of Water
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Men (3.7L total, 3L(101oz) w/o food) Women (2.7L total, 74oz w/o food)
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How Much Before Exercise
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5-7 ml/kg 4 hours before exercise
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How Much to Replenish During Exercise
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16-24oz for every pound
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Diseases That Can Impact Water
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Uncontrolled Diabetes Mellitus r/t hyperglycemia->replace lost water and electrolytes stat in these cases
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Metabolic Needs
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1000 ml for every 1000 kcal
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High fluid intake is extremely important in
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infants via breast milk, body content of water is 70 to 75%
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Caffeine and Alcohol
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don't cause a net water loss
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Symptoms of dehydration are apparent
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2% of normal body weight is lost.
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Initial symptoms of dehydration are
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thirst, headache, decreased urine output, dry mouth, and dizziness
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Worse dehydration can lead to
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visual impairment, hypotension, loss of appetite, muscle weakness, kidney failure, and seizures
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Chronic or Severe dehydration can lead to
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increased resting HR, kidney infections, gallstones, constipation, decreased cognition, exercise performance, and thermoregulation; coma and death
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Fluid losses of > 10% body weight
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medical assistance for a complete recovery
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Decreased Thirst sensation and fluid loss can happen in
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older adults
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Water Intoxication can happen in
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renal insufficiency or neurologic disorders affecting the thirst mechanism, people who take part in endurance exercise, psychiatric pt w/ polydipsia, pt taking psychotropic drugs
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Water Intoxication causes
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edema, lung congestion, and muscle weakness
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Normal Body Water Content
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45% to 75% of body weight in adults; Men have 10% more than women for an average of 60% and 50% respectively
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Muscle contains
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significantly more water than fat tissue
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Extracellular fluid
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makes up 20% of body weight, and is found in blood plasma, in lymphatic circulation, and moves through the body in various tissue secretions, and contains transcellular fluid
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transcellular fluid
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consists of water within the gastrointestinal tract, cerebrospinal fluid, ocular and joint fluid, and urine within the bladder
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intracellular fluid
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twice the amount of extracellular fluid
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2.5 to 3 liters of water
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is metabolized by the body per day between intake and output
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water intake
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1) preformed water in liquids that are consumed, 2)preformed water in foods that are eaten, 3) as a product of cell oxidation when nutrients are burned in the body
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xerostomia
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dry mouth, common in older people, and common with certain medications
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Minimum fluid intake
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1500 to 2000ml per day
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Thirst
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indicates current dehydration
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Water exits through
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kidneys(Most), skin, lungs, and feces
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Output on average
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2400ml's per day
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electrolytes
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small inorganic substances that can dissociate or break apart in solution and that carry electrical charge.
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cations
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positively charged ions (Na+, Ca+, Mg^2+)
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Anions
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negatively charged ions (Cl-)
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Electrolytes balance
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The charge between ICF and ECF
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Electrolytes and fluid
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are intimately related, an imbalance in one will do so to the other
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Electrolyte concentrations are measured
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in mEq
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mEq
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represent the number of ionic charges or electrocovalent bonds in a solution
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Plasma proteins
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are larger than electrolytes, control water movement, and maintain blood volumes by influencing the shift of water in and out of capillaries, known as colloids
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colloidal osmotic pressure
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the fluid pressure that is produced by protein molecules in the plasma and the cell; because proteins are large molecules, they do not pass through the separating membranes of the capillary walls; thus, they remain in their respective compartments and exert a constant osmotic pull that protects vital plasma and cell fluid volumes in these areas
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hyperglycemia can cause
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polyuria
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Cell Membranes
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contain channels in the phospholipid bilayer that are highly specific to the molecules that are allowed to pass (i.e. Na channels for Na)
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osmosis
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movement of water molecules from low solute concentration to high solute concentration
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osmotic pressure
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pressure produced by osmosis
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diffusion
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movement of particles in a solution from greater concentration to lower concentration
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facilitated diffusion
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same as diffusion +specific transporters
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filtration
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water is forced through pores of membranes through pressure differences
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active transport
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driven by energy; force particles "upstream"
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Pinocytosis
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Nom Nom Pacman
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Capillary Fluid Shift Mechanism
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balances fluid pressures; maintains water balance
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Nutrients are transported throughout the body
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through opposing fluid pressures->hydrostatic pressure is an intracapillary blood pressure from the contracting heart muscle pushing blood into circulation, and COP is pressure from the plasma proteins drawing tissue fluids back into the ongoing circulation.
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Two major organ systems help protect homeostasis
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Gastrointestinal, Renal
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These gastric secretions are primarily water
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saliva, gastric juice, pancreatic juice, and intestinal juice
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Gastrointestinal circulation
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a large movement of water and electrolytes from the latter part of the intestine are absorbed into circulation and reused. carries great clinical risk if balance is upset.
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law of isotonicity
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state of equal osmotic pressure resulting from equal concentration of electrolytes and other solute particles
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greatest causes of fluid and electrolyte problems
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NVD, IE problems of the upper and lower intestinal tracts
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Renal Circulation
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kidneys maintain blood levels by "laundering" i.e. filtering the blood and selectively reabsorbing needed water and materials
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Clinical Application of Renal Circulation
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When "laundering" does not happen normally, water imbalances occur
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Antidiuretic Hormone
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ADH promotes reabsorption of water, production of concentrated urine. released from pituitary gland, stimulated by high blood osmolarity by hypothalamus, low blood pressure by heart. acts in distal convoluted tubules, decrease in urine volume, increase in urine concentration.
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Renin-Angiotensin-Aldosterone
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Angiotensinogen (liver; inactive large protein)-->Renin catalyzes-->Angiotensin I (weak)-->Catalyzed by Angiotensin Converting Enzyme-->Angiotension II (bully; vasoconstricts everything; stimulates Adrenal Cortex to release Aldosterone-->^reabsorption of Na+ & H2O)
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Acid
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A substance that increases the hydrogen ion concentration of a solution, or has more H ions
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Base
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A substance that reduces the hydrogen ion concentration in a solution, or has less H ions.
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Acid-Base Buffer System
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Body contains many ways to deal with pH normal pH is 7.35-7.45
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chemical buffer system
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a mixture of acidic and alkaline components that together protect a solution from wide variations in its pH.
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H2CO3 (carbonic acid)
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can be readily produced by the body with H2O CO2
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Base-to-Acid Ratio
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is 20:1: bicarbonate base is 20 times more abundant than H2CO3; ECF pH is held constant
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Physiological Buffer Systems
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when chemical buffers cannot reestablish equilibrium, respiratory and renal systems respond
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Respiratory response
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Hyperventilation->acidosis; hypoventilation->alkalosis
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Renal response
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When Chemical and and Respiratory systems fail; Renal response kicks in; kidneys can excrete more or less hydrogen ions, if acidic kidneys will Nom Nom hydrogen ions in exchange for Na; hydrogen ions are acidic and Na is basic; thus restoring the blood to balance.
