NUTRITION

MRS. PARIMALA RNRM

M.Sc NURSING 1st year
CHILD HEALTH NURSING
 INTRODUCTION

Water is made of tiny molecules of hydrogen and oxygen.

 each one is so small that you cant see it even with the
most powerful microscope.
 pure water has no colour,taste,and smell.
WATER AND ELECTROLYTES
 DAILY REQUIREMENT OF WATER
 Requirement of water vary with climate dietary,
constituent, activities and surface area of the body.
As a person should take enough water to excrete about
1200-1500ml of urine per day. In tropics because of
greater water loss through perspiration increased water
intake is required to maintain urine volume.
noraml intake of water ranges betwwen 8 & 10 glasses
per day.
 DRI by food and nutrition board
AGE WATER
0-6 months 0.7 L/day of water assumed to be
from human milk.
7-12 months 0.8 L/day of water assumed to be
human milk an complementary foods
and beverages.
1-3 yrs 1.3 L/day
4-8 yrs 1.7 L/day
Boys 9-13 yrs 2.4 L/day
Girls 9-13 yrs 2.1 L/day
Boys 14-18 yrs 3.3 L/day
Men 19-70+ 3.7 L/day
Women 19-70+ 2.7 L/day
 FACTORS THAT AFFECT WATER
REQUIREMENT
Environment
Level of activity
Physiological stress
kidney diseases
FUNCTIONS OF WATER
 FUNCTIONS OF WATER
Transport nutrients to the cells and carries waste products
away from the cells.
Maintains blood volume
Regulates body temperature
Serves as aqueous medium for cellular metabolism
Assists in digestion of food through hydrolysis.
conti....
• Medium for various
physical process:
It acts as a medium for
various physical process
such as
osmosis,diffusion,filtration,
etc.
PERCENTAGE OF WATER IN THE BODY
Total Body water varies
depending on body fat:
infants :73%
male adult:60%
female adult :40-50%
effects of obesity
DISTRIBUTION OF WATER
 DISTRIBUTION OF WATER IN THE BODY

• The total body water is distributed through out two main

compartments:
»Extra cellular fluid
»Intra cellular fluidS
 INTRACELLULAR FLUID
• Intra cellular fluid :
Intra cellular fluid is the
fluid that exists within the
cells of multi -cell organisms.
 EXTRA CELLULAR FLUID (ECF)
The extra cellular fluid denotes all body fluid outside the
cells of any multi cellular organism.
The extra cellular fluid compartment is divided into
- Intestitial fluid volume
- Intra vascular volume
 INTESTITIAL FLUID VOLUME
Its found in the intestitial spaces. It is the fluid outside
both cells and the blood vessels.
Intestitial fluid surrounds cells, providing them with
nutrients and removing their waste products.
Its contains a great deal of connective tissue and protein.
 BODY FLUID

INTRACELLULAR FLUID EXTRACELLULAR FLUID

BLOOD PLASMA INTERSTITIAL FLUID

VENOUS VOLUME ARTERIAL VOLUME TRANCELLULAR FLUID LYMPHATIC FLUID

 TRANSCELLULAR FLUID
Transcellular fluid is the portion of total body water
contained within the epithelial lined spaces. Ex: cerebro
spinal fluid, joint fluid, plural cavity.
 INTRA VASCULLAR FLUID:
Intra vascullar fluid is found inside the blood vessels.
Approx 20% of ECF is found in plasma.
Plasma travels through the body in blood vessels and
transport range of materials, including blood cells,
protiens, electrolytes, nutrients, gases and wastes.
 REGULATION OF WATER
Regulation of water content in the human body is achieved
by blancing the daily water intake and output.
• The thirst center located in the third ventricle in
hypothalamus, which is stimulated by ECF hyper osmaolality
and hypovolemia and inhibited by hypo osmolality and
hypervolemia.
• Vasopressin or Antidiuretic hormone (ADH), the anterior
pituitary hormone that enhances water reabsorption in
response to an increase in ECF osmality or hyprovolemia.
 COMPOSITION OF BODY FLUIDS
• Body fluids contain water and solids.solids are organic an
inorgonic substances.
organic substances :
Glucose,amino acids,fatty acids,hormones an enzymes
• Intra cellular fluid composition:
• The intra cellular fluid has elevated amounts of
pottasium,magnisium and protien,most of the cytosol is water.
• The cell membrane separates cytosol from extracellular fluid.
 cont..
• cytosol has a high concentration of potassium ions an low
concentration of sodium ions.
 Extracellular fluid composition
• Its mainly cations and anions the cations include
sodium,potassium,and calcium.anions includs
chloride and hydrogen carbonate.these are important
for water transport though out the body.
• Plasma and ecf contain high concentration of sodium
and chloride.
Plasma composition:
• Plasma is mostly water[93%]and contains disolved
.protiens hormones ,and corbon dioxide.its helps to
immune syste function and drug distribution
throughout the body.
 conti...
Lymph is the fluid found in the lymph.the electrolyte
content of tymph is similar to that of plasma.
Interstetial fluid:
The interstetial fluid has high concentration of sodium
chloride and bi carbonate
Trans cellular fluid composition:
Some of the electrolytes present in the transcellular flui
are some ions,chlorideions,and bicorbonate ions.
cerebro spinal fluid is similar in composition to blood blood
plasma
 WATER INTOXICATION
• Water intoxication is a potentially fatal disturbance in brain
fuctions that results when the normal balance of
electrolytesin the body is pushed outside safe limits by
over -hydration.
• Symptoms:
Head ache,nausea,muscular weakness and delirium
are the main symptoms.
 contin..
• Causes:
This condition is caused by excess of water retention in the
body and can occur due to:
Renal failure
Excessive administration fluids parentically
Hypersecretion of ADH
Risk factors:
low body mass[infants]
it can be very easy for chilren under one year old because of
their small body mass.
 Continu...
Endurance sports-
Marathan runnars are susceptible to water
intoxication(when water is consumed to replace lost)
Overexcretion and heat stress:
Any activity or situation that promotes heavy sweating can
lead to water intoxication.when water is consumed to replace
lost fluids.
 cont..
Psychiatric conditions:
Psychogenic polydipsia is the condition in which patients
feel compelled to drink large quantity of water ,thus putting
them at risk of water intoxication.
Introgenic :
when an unconscious person is being fed intravenously or
via a nasogastric tube,these fluids are typically hypertonic,if
the electrolytes are not monitored either hypeonatremia or
 conti..
hyponatremia may result.
PREVENTION:
The best way to prevent water intoxication is to drink
liquids in moderateion and t ensure that daily diet includes
sufficient electrolytes.
TREATMENT:
Mild intoxication may remain asymptamatic and require
only fluid restriction in more severecases,treatment consist
of -
Diuretics to inceaseurination,which are most effective for
excess blood volume.
 DEHYDRATION
• Excessive loss of fluid
from the body-occurs
when the loss of fluid
exceeds the fluid intake.
 contin...

Causes:
Excessive fluid loss,reduced fluid intake,a combination of
these factors can cause fluid volume losses.
Other causes:
 hemorrhage
vomitting and diarhoea
abdominal surguries
nasogastric drainage
 conti...

• acute renal failure with poly uria

• Signs and symptoms:
Dehydration includes:
thirst
head ache
general discomfort
decreace urine volme
tiredness
 Complications or Risk factors

 Hypotention and decrease cardiac output and perfution

to tissues and organs.
severe dehydration can
progress to hypovolemic shock
Renal failure from decreased
renal perfusion and without
intervention death
 REHYDRATION
• It can be prevevented by
taking
suffcient amounts of water
as fluids.
the correction of dehydration
is called
rehydration.
 contd...
Treatment:
The treatment for minor dehydration
that is often considered the most
effective is drinking water and stop fluid loss
 conti...
• Treatment:
oral rehydration theraphy-
It is the administration of
fluid
to prevent or correct
dehydration.
 cont...
Tender coconut water:
It contains most of the minerals such as
potassium,
sodium,
calcium,
magnisium,
phosphorus,
iron and copper
 its an oral rehydration medium and keeps the body cool.
 OVER HYDRATION
Definition :
It is the condition in which the
body contains too much water.
it occurs when the body takes in
more water then its excrets and
its normol sodium level is
diluted.
 conti..
Symptoms:
digestive problems.
behavioural changes.
brain damages.
seizures or coma.
brain cells are particularly susceptible to over hydration and
low sodium level in the blood.
 conti...
Causes :
This condition most common in patients whose kidney
functionis impaired and may occur when more amount of
water producing fluids and medications is administered to
patients body than the patient can excrete.
 cont...
Treatment:
Restriction of fluid intake.
if over hydration occurs with
excess blood volumebecause
of heart,kidney disease,restricting
the intake of sodium is also helpful
because sodium causes the body to
retain water.[diuretics]