Copyright © 2015. F.A. Davis Company W ATER C HAPTER 8: W ATER.

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<ul><li> Slide 1 </li> <li> Copyright 2015. F.A. Davis Company W ATER C HAPTER 8: W ATER </li> <li> Slide 2 </li> <li> Copyright 2015. F.A. Davis Company W ATER Single largest body substance More than half body weight Muscle tissue is 70% water Fat tissue is 30% water Bone tissue is 10% water </li> <li> Slide 3 </li> <li> Copyright 2015. F.A. Davis Company F LUID C OMPARTMENTS Intracellular Extracellular Interstitial Intravascular Lymphatic Transcellular </li> <li> Slide 4 </li> <li> Copyright 2015. F.A. Davis Company F UNCTIONS Gives the body shape and form Helps maintain blood volume and pressure Serves as a lubricant Helps regulate body temperature Acts as a solvent for minerals, glucose, and other small molecules </li> <li> Slide 5 </li> <li> Copyright 2015. F.A. Davis Company A BSORPTION Small amount in the bloodstream Larger amounts from the intestines Retained in certain disease processes (edema) of interstitial fluid: Heart failure Kidney diseases Lymphatic/venous blockages Sodium retention Protein deficiency </li> <li> Slide 6 </li> <li> Copyright 2015. F.A. Davis Company W ATER I NTOXICATION Excessive water intakeintravenous or gastrointestinal Cerebral concussion Hormonal disorders </li> <li> Slide 7 </li> <li> Copyright 2015. F.A. Davis Company D IETARY R EFERENCE I NTAKES 80% from fluid intake 20% from food intake Increase consumption when physically active Infants receive adequate amounts via breast milk Watch older adults because thirst mechanism may be altered </li> <li> Slide 8 </li> <li> Copyright 2015. F.A. Davis Company W ATER B ALANCE IN THE B ODY Osmotic pressurehypotonic, hypertonic, isotonic Sodium potassium pump Serum electrolytes </li> <li> Slide 9 </li> <li> Copyright 2015. F.A. Davis Company C LICKER Q UESTION It is especially important to monitor the elderly for fluid balance because of: A. Potential for changes in body temperature B. Changes in skin turgor C. Potential for alterations in thirst mechanism D. Cognitive changes </li> <li> Slide 10 </li> <li> Copyright 2015. F.A. Davis Company A NSWER Correct Answer: C Potential for alterations in thirst mechanism Rationale: The thirst mechanism is the bodys way of helping to maintain water balance, and this can be altered in the elderly. </li> <li> Slide 11 </li> <li> Copyright 2015. F.A. Davis Company P LASMA P ROTEINS AND W ATER B ALANCE Hydrostatic blood pressuresystolic and diastolic Colloidal osmotic pressurealbumin Malnutritionkwashiorkor </li> <li> Slide 12 </li> <li> Copyright 2015. F.A. Davis Company W ATER B ALANCE I NTAKE AND E XCRETION Intakethirst mechanism Excretiontwo hormones Aldosteronecauses body retain sodium Antidiuretic hormonecauses body retain/reabsorb water </li> <li> Slide 13 </li> <li> Copyright 2015. F.A. Davis Company W ATER I MBALANCES Diabetes insipidus - A chronic metabolic disorder causing intense thirst and excessive urination, caused by a deficiency of the pituitary hormone vasopressin. Syndrome of inappropriate antidiuresis hormone (SIAD) </li> <li> Slide 14 </li> <li> Copyright 2015. F.A. Davis Company SIAD C AUSES Central nervous system disorders (infections, hemorrhage, multiple sclerosis) Lung disease (pneumonia, tuberculosis, cystic fibrosis) Some tumors (oat cell of lung, carcinoma of pancreas, lymphoma, leukemia) Certain drugs (selective serotonin reuptake inhibitors or SSKIs [saturated solution of potassium iodines], chemotherapeutic agents, antidepressants) Surgery-induced severe nausea, pain </li> <li> Slide 15 </li> <li> Copyright 2015. F.A. Davis Company A CID B ASE B ALANCE Acidity or alkalinity is measured by a scale called pH for potential of hydrogen The pH scale ranges from 0 to 14: Acids are rated 0 to 6.999; 7.0 is neutral Bases (alkalis) are greater than 7 </li> <li> Slide 16 </li> <li> Copyright 2015. F.A. Davis Company E XTRACELLULAR F LUID The normal pH of the extracellular fluid is 7.35 to 7.45 The body continually works to maintain pH within a narrow range </li> <li> Slide 17 </li> <li> Copyright 2015. F.A. Davis Company R ESPIRATORY S YSTEM The lungs help maintain pH The respiratory response to acidosis begins within minutes The first-aid recommended for hyperventilation resulting from anxiety is breathing through only one nostril with the mouth closed. The previous technique, breathing into a paper bag, can lead to hypoxia (Venes, 2013) </li> <li> Slide 18 </li> <li> Copyright 2015. F.A. Davis Company R ENAL S YSTEM The kidney excretes or retains hydrogen, sodium, and bicarbonate ions to maintain pH in blood The kidneys initiate these actions within 24 hours Require 3 to 4 days to compensate for changes in blood pH </li> <li> Slide 19 </li> <li> Copyright 2015. F.A. Davis Company C LICKER Q UESTION The two body systems most closely effecting pH are: A. Gastrointestinal and renal B. Renal and cardiac C. Respiratory and cardiac D. Renal and respiratory </li> <li> Slide 20 </li> <li> Copyright 2015. F.A. Davis Company A NSWER Correct Answer: D Renal and respiratory Rationale: Renal (more slowly) and respiratory (more rapidly) perform functions to bring the body pH back into a narrow margin of balance. </li> <li> Slide 21 </li> <li> Copyright 2015. F.A. Davis Company W ATER B ALANCE /I MBALANCE Daily weight is the single most important indicator of fluid status Weight changes can be caused by metabolic events as well as by fluid shifts </li> <li> Slide 22 </li> <li> Copyright 2015. F.A. Davis Company T HIRD S PACE L OSSES Large amounts of fluid can accumulate in several places in the body outside the circulatory system Third-space losses involve internal bleeding, collection of fluid in the chest cavity, or abdomen ascites - an abnormal accumulation of fluid in the abdomen. An alert nurse can spot an early clue to third- space losses: decreasing urine output despite seemingly adequate fluid intake </li> <li> Slide 23 </li> <li> Copyright 2015. F.A. Davis Company S ENSIBLE /I NSENSIBLE W ATER L OSSES Sensible Perspiration Urine Gastrointestinal Insensible Lungs Skin </li> </ul>

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