BSN111 Applied Nutrition for Nurses PDF, 2023/2024

BSN111 Applied Nutrition for Nurses The Role of Minerals in Maintaining Health 2023 / 2024 Semester 3 – Week 3- B By: Firas Qatouni, RN., M.Ed., Copyright © 2019, 2011 Pearson Education, Inc. All Rights Reserved...

BSN111 Applied Nutrition for Nurses The Role of Minerals in Maintaining Health 2023 / 2024 Semester 3 – Week 3- B By: Firas Qatouni, RN., M.Ed., Copyright © 2019, 2011 Pearson Education, Inc. All Rights Reserved 1  Minerals As like the vitamins, the main function of minerals is to regulate body functions. Minerals must be INGESTED everyday – and are found in foods like fresh fruits & vegetables, nutrient dense protein foods and whole grains. To get enough of each vitamin or mineral, it is best to always eat a wide and colorful variety of products. Metabolism Do not break down during metabolism. Na+ Na+ Can combine with other compounds or elements. Na+ + Cl- NaCl Do not contain a source of energy. 3  Functions of Minerals 1. Provide structure: Bones, teeth, and soft tissues. 2. Maintain fluid balance. Osmosis 3. Serve as cofactors and coenzymes for metabolic and hormonal reactions. 4. Play role in nerve transmission and muscle contraction. Na+ , K + Pump 4  Minerals Function Ca Cu  Minerals Function Fe Mg  Minerals Function Mn  Minerals Function P Se  Minerals Function Na Zn  Mineral Classification Sixteen essential minerals are needed in the diet for health. Body cannot make these nutrients & Requires them from the diet. Classified as: 1. Major minerals: Present in the body in amounts of 5 gm or more. Require an intake of at least 100 mg/day. 2. Trace minerals: Present in amounts less than 5 gm. Have recommended intakes of under 100 mg/day. 10  What Are the Major Minerals? Calcium Phosphorus Magnesium Sulfur Sodium Potassium Chloride 11  Calcium Important part of the matrix that makes bone and teeth. Bones serve as a storage depot of the mineral. Dietary Recommended Intake (DRI) Age 19 to 50, the Adequate Intake (AI) is 1000 mg of calcium daily. Over age 50, the daily recommendation increases to 1200 mg Medical conditions and medications may affect intake requirements. Adequate levels can play a role in: Blood pressure control. Reduction of symptoms of Premenstrual syndrome 12  Calcium Major sources: milk and other dairy foods. Some green leafy vegetables, Fish with small bones. Bioavailability varies among foods. Absorption is improved in the presence of adequate vitamin D stores. Deficiency occurs because of: Chronically insufficient intake Altered absorption or metabolism Increased losses of calcium 13  Calcium Deficiency Hypocalcemia: Affects muscle contraction and nerve conduction, leading to Tetany. Osteopenia  Bone Mass / Thin bone Osteoporosis Prevention and treatment of osteoporosis include an adequate intake of calcium and vitamin D. 14  Calcium Toxicity Tolerable Upper Intake Level (UL) is 2500 mg/daily. Hypercalcemia can lead to soft tissue deposits of calcium, renal damage, and death. Calcium negatively interacts with iron, zinc, magnesium, and phosphorus absorption. Nurse should advise patients to avoid taking calcium supplements with meals or with other iron- containing supplements. 15  Phosphorus Majority exists in bone. Constituent of phospholipids and lipoproteins. Body seeks to maintain steady state between absorption and excretion. RDA is 700 mg for adults. All plant and animal foods contain phosphorus. Protein-rich foods tend to have more phosphorus content. 16  Phosphorus Aluminum-containing and calcium carbonate antacids and dietary supplements can alter phosphorus absorption. Intracellular shifts of phosphorus occur with changes in cellular pH. Hypophosphatemia: Rarely occurs from diet 17  Hyperphosphatemia Elevated plasma phosphate level Result of renal failure or Result of vitamin D intoxication Can alter hormonal balance of plasma calcium. Controlled with phosphorous- binding medication. 18  Magnesium Found primarily in bone and soft tissue. Kidney is the organ primarily responsible for maintaining magnesium homeostasis. Function: Maintenance of normal heart rhythm. Essential in the regulation of sodium, potassium, and calcium homeostasis. 19  Magnesium Recommended Daily Allowance (RDA): 1. Adults 19 and 30 years old Males 400 mg Females 310 mg 2. After age 30 Males 420 mg Females 320 mg Best sources include: Leafy vegetables, Whole grains, Seeds, and Nuts. 20  Magnesium Deficiency Occurs with: Poor-quality diet. High intake of processed foods. Overall diminished intake. Malabsorption conditions. Renal wasting due to alcohol, diuretics, certain antibiotics, and chemotherapeutic agents 21  Hypomagnesemia Magnesium not generally assessed in routine testing. Cardiac patients on diuretic therapy are at risk. Signs: Neuromuscular hyperexcitability. Concurrent hypokalemia. Hypocalcemia. Increased intracellular calcium. 22  Electrolytes Sodium Na+ Potassium K+ Chloride Cl- Can exist in ionically charged forms, exerting an effect on: Fluid concentration. Acid-base balance. Nerve conduction. Membrane permeability. 23  Sodium and Chloride Generally found together in the food supply as sodium chloride. Commonly referred to as salt. Balance maintained by hormones, sympathetic nervous system, and intrarenal mechanisms. 24  Function of Sodium and Chloride Plays a central role in maintaining plasma volume by contributing to ECF osmolality. Sodium is responsible for maintaining cell membrane potential and active transport of substances across cell membranes. Chloride is a constituent of hydrochloric acid in stomach. 25  Sodium and Chloride Adequate Intake (AI): Sodium Age 19 to 50 years is 1.5 gm per day Chloride Age 19 to 50 years is 2.3 gm per day Does not apply to individuals with a large volume of sodium and fluid loss. 26  Sodium and Chloride Excess sodium losses in sweat can occur with intense exercise, working in extreme heat, and with cystic fibrosis. Hyponatremia: Treated emergently as it has severe negative consequences. Reduced sodium is associated with improved blood pressure control in normotensive and hypertensive individuals. Excess sodium intake fosters increased excretion of urinary calcium. 27  Sodium and Chloride Use of salt supplements is not recommended as a usual practice unless medically advised. 28  Potassium Found within cells and in extracellular fluids Delicately balanced to affect: Neural transmission Muscle contraction Maintenance of fluid balance Sources: Fruits (In particular bananas, dried fruit, and melons), Vegetables, Legumes, & Milk. 29  Hypokalemia Alters capacity of the pancreas to secrete insulin. Risk of HTN, Stroke, & Kidney stones. Deficiency: Reduced intake Increased losses Combination of reduced intake and increased losses Elevated plasma potassium is a risk factor for life- threatening cardiac arrhythmias. 30  Trace Minerals What Are Trace Minerals? Iron Iodine Zinc Selenium Copper Fluoride Chromium Molybdenum Manganese 31  Trace Minerals Present in the body in amounts less than 5 grams Daily requirement is less than 100 milligram. 32  Iron Essential for oxygen transport. Storage occurs primarily in liver, spleen, and bone marrow. RDA Men age 19 and older is 8 mg. Women: 18 mg daily until age 50. 27 milligram per day during pregnancy. Deficiency can occur from: Poor diet. Poor iron bioavailability or absorption. Increased iron losses.  Symptoms of Iron deficiency Decreased efficiency of oxygen delivery. Fatigue, diminished work performance, and increased heart rate can occur. Children may have impaired brain development and problems with cognition or social development. Difficulty in maintaining body temperature. Koilonychias: Upward curved and ridged fingernails. Pica: Craving for and ingesting of nonfood items. 34  Trace Minerals Zinc: Plays an important role in immune response. Homeostasis regulated in part by GI tract. Vegetarians may require up to 50% more in diet than non vegetarians. Selenium: Antioxidant. Maintenance of thyroid and immune function. RDA is 55 mcg for all adults. Beef, poultry, seafood, and Brazil nuts. 36  Trace Minerals Copper Knowledge about copper requirements is evolving. Important in collagen and connective tissue synthesis. Widespread in diet. Organ meats, seafood, nuts, grains, proteins. Fluoride Approximately 99% of body’s fluoride is found in calcified tissue. Aids in mineralization of bone and teeth. Can assist in stimulation of new bone formation, lifelong resistance to dental caries. 37  Fluoride Primary source is drinking water and beverages made with it. Dental products such as rinses, gels, and foams also supply fluoride. Inadequate intake has been shown to increase risk of dental caries. Prevalence is low. Risks of excess exposure in children: Skeletal fluorosis. 38  Iodine Comprises majority of weight of two thyroid hormones responsible for regulation of temperature, metabolic rate, and enzyme action in the body: Thyroxine (T4) Triiodothyronine (T3) RDA: 150 mcg per day for adults. Content varies depending on soil where plants are grown or feed given to animals. Seafood is a good dietary source. 39  Iodine Deficiency 1. Is a common cause of preventable brain damage in the developing fetus and infant. 2. Alters production of thyroid hormones. 3. Congenital hypothyroidism. 4. Goiter. Tolerable Upper Intake Level (UL) is 1100 mcg per day. Toxicity is rare. Can occur in those with thyroid autoimmune disease or those who chronically consume more than U L Nurse should be aware of significant iodine content in the following: Amiodarone; Contrast dye; Food coloring; Water purification tablets.  Nonessential Trace Minerals Arsenic Boron Nickel Silicon Vanadium 41