Transcript lecture 9x

Fluid & Electrolyte Balance
HLTH 120N; Lecture 9
Objectives
Describe 3 reasons fluid composition varies.
Identify the 4 electrolytes and their 3
functions. Identify the other mineral
essential for muscle contraction.
 Indicate the 4 main functions of body fluids.
 Know your recommendations for water,
sodium & potassium.
 Explain how to effectively hydrate to
support exercise
 Describe what occurs with dehydration, heat
stroke, and hypertension.


Body Fluid

The liquid portion of cells and tissues

Able to move freely, adapting to the shape
of the area that contains it

About 50−70% of healthy adult body
weight

Intracelluar fluid: within the cell
◦

of body fluid
Extracellular fluid: outside the cell
◦
of body fluid
◦ Interstitial fluid flows between cells that make up a
particular tissue
◦ Intravascular fluid is in the blood and lymph
 Plasma transports blood cells within arteries, veins, and
capillaries
Fluid composition varies by:

Tissue type
◦

Gender
◦

tissues
tissues have higher fluid content than
more
Age
have more lean tissue, so they have
.
◦ With age, lean tissue is lost so
body water
.
Electrolytes

Predominant electrolytes
◦ Extracellular fluid:
◦ Intracellular fluid:

, chloride
, phosphorus
Dissolved substances that disassociate in
solution into electrically charged particles
◦ Positive charge:
◦ Negative charge:
,
.
,
.
Body Fluid Functions

Dissolve and transport substances
◦ Water is an excellent solvent
◦ Water-soluble substances are easily
transported in the bloodstream:

, AA’s, glucose, minerals, meds
◦ Fatty substances?
Fluid Functions cont.

Account for blood volume
◦ Correct body fluid levels maintain a healthful
blood volume
◦ Blood pressure
when volume rises
◦ Low blood pressure

◦ Kidneys help regulate blood volume
and pressure
Blood Volume/Pressure Regulation

Renin responds to decreased blood
pressure

Anti-diuretic hormone
◦

Angiotensin II (vasoconstrictor)

Aldosterone signals the kidneys to retain
sodium & chloride to retain water
Fluid Functions Cont.

Help maintain body temperature
◦ Must be within a safe range
◦ Only sustained high heat can increase body
temperature
◦
releases heat as water evaporates
to cool skin and blood
Fluid Functions Cont.

Protect and lubricate tissues
Examples:
◦ Cerebrospinal fluid ◦ Amniotic fluid ◦ Synovial fluid lubricates ◦ Tears cleanse & lubricate ◦ Saliva moistens food for swallowing
Fluid Function Recap




Electrolyte Functions

Help regulate fluid balance
◦ Cell membranes are permeable to water,
not electrolytes
◦ Water moves by osmosis to areas of
solute concentration
 Provides control of water movement in & out of the cells
Electrolyte Function Cont.

Enable nerves to respond to stimuli
◦ Nerve impulses are initiated at nerve cell
membranes in response to a change in
electrical charge across the membrane
◦ Sodium & potassium ensure nerve impulses
are generated, transmitted, and completed
 Depolarization—Action Potential—Repolarization
Electrolyte Functions Cont.

Signal muscle contractions
◦ Muscles contract in response to stimulation
of nerve cells
◦ Influx of
into the muscle
causes contraction
◦ Muscles relax after contraction once the
electrical signal is complete and calcium is
pumped out of the muscle cell
Thirst & Fluid Balance

Like hunger, thirst is signaled by the
with
◦ Increased salt & substances in the blood
◦ Reduced blood volume & pressure
 Can occur with profuse sweating,
diarrhea, or low
.
◦ Dry mouth and throat from reduced saliva

Anti-diuretic hormone will signal the
to retain water
,
Water Loss

Sensible water loss
◦ Kidneys excrete water as urine
◦ Sweat during exercise/hot environment

Insensible water loss
◦ Skin (not sweating) or lungs

Significant loss
◦ Illness, injury, exercise, high altitude, pregnancy,
breastfeeding, diuretics

Supports all body functions

Fluid Recommendations:
◦ Women:
Men:
 Can be very individualized
 Lost water from
&
replaced

Best Food Sources:
must be
Water Balance Issues

Deficiency
◦ Fluid in < Fluid out
◦ One of the leading causes of death around the
world:
◦ Hypernatremia:

Toxicity
◦ Hyponatremia: dilution of blood sodium
 Very rare; occurs mostly in
.
Sodium
charge
 Functions

-cellular
◦ Exchanges with potassium for fluid balance,
pH balance, blood pressure
◦ Transmits nerve signals
◦ Aids in glucose absorption

RDA:
◦ Most Americans consume:
◦ AHA, ADA recommend under:
Hypernatremia/High intake
Hyponatremia/Low intake
◦ Hypertension
◦ Osteoarthritis/osteoporosis
◦ Type II Diabetes
◦ Respiratory complications
◦ Gallbladder disease
◦
blood pressure
◦ Poor kidney function
◦ Heart failure
◦ Cirrhosis of liver
Sodium Imbalance
Potassium

Functions:
◦ Fluid balance, nerve impulses
RDA:
 Sources


Toxicitiy –
◦ weakness, vomiting, irregular heartbeat

Deficiency◦ weakness, paralysis, confusion, high BP
Chloride

Functions:
◦ Fluid balance, nerve impulses
◦ In the stomach as
, aids white blood cells


Best Source:
Deficiency is rare
Phosphorus

Role:
◦
◦
◦
◦

Component of body’s energy source:
80% of body phosphorus is in:
Buffering agent
In the cell membrane, forms:
Sources: meat, nuts, seeds, fish, veggies
◦ High amounts in bottled/canned beverages

Toxicity:
◦ Renal disease, Vit D Supp’s, Antacids
◦ Causes spasms & convulsions
Dehydration

Fluid losses
◦ Causes:
fluid intake

Classified by % weight loss from fluids

Small losses:

Severe loss:
◦ Sleeplessness, nausea, flushed skin, poor
concentration
 Untreated: cardiac arrest, coma, death
Fluid replacement & exercise

Consume water before, during, after
◦
◦
◦
◦

2-3 hours prior:
30-60 min prior:
During <1 hr:
During >1 hr:
Measure body weight before & after
◦ For each lb lost, consume
.
Urine Color Chart
Heat Stroke

Fatal heat illness
◦ Failure of body’s heating mechanisms
◦ Rapid pulse, hot skin, loss of consciousness

Most vulnerable?
◦ More muscle mass = greater heat production

Ability to lose heat through sweat very
limited in humid environments
Hypertension


Inability to maintain blood pressure in a
healthy range
% of US adults hypertensive

Increases risk for:

Reduces brain function, impairs mobility
Type of blood pressure

Systolic
◦ Pressure arteries exert during contraction.
___________________

Diastolic
◦ Pressure in arteries during
Optimal:
 Pre-hypertensive:
 Hypertensive is > 140/90

.
Causes of hypertension

Primary cause unknown for 90-95%

5-10% from kidney disease, sleep apnea,
alcohol abuse

Over half have salt sensitivity

Others are salt resistant
5 lifestyle changes

◦ 5-10%



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The DASH diet

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Low-fat & high fiber

Encourages potassium, calcium, magenesium
◦ 10 servings fruits & vegetables/day

Sodium <3g

Blood pressure lowers within __________

The lower sodium intake, the better

Also reduces risk of _________________
Fluid & electrolyte considerations

Neuromuscular issues:
◦ Seizures – due to nerve impulse issues
◦ Muscular dystrophy
◦ Muscle cramps – involuntary spasms

Obesity
◦ 21% of calories come from beverages
◦ Researchers believe sweetened beverages
contribute to half the rise in calorie intake
DASH diet assignment

Create a 2,000 calorie diet meeting DASH
diet guidelines

Enter the diet into MyDiet Analysis

Hand in the list of foods with the print out
of nutrients for that day

1 paragraph: How does this diet compare to
your own? Should it only be recommended
with hypertension?