HS 331: Chapter 7 Lecture - Electrolytes and Fluid
HS 331: Chapter 7 Lecture - Electrolytes and Fluid HS 331
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This 7 page Class Notes was uploaded by Sydney Brummett on Monday September 26, 2016. The Class Notes belongs to HS 331 at Wichita State University taught by Dr. Lisa Wray in Fall 2016. Since its upload, it has received 41 views. For similar materials see Principles of Diet and Nutrition in Health Sciences at Wichita State University.
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Date Created: 09/26/16
Chapter 7 Lecture: Nutrients Involved in Fluid and Electrolyte Balance • Fluids o Substances composed of freely moving molecules o Have the ability to conform the shape of the container that holds them o There are different types of fluids in our bodies § Two-thirds of the body’s fluid is intracellular fluid • In the cell § The remaining one-third is extracellular fluid • Outside the cell o Extracellular fluids include: § Tissue fluid, found between the cells within tissues and organs of the body § Plasma: the fluid portion of blood that carries the blood cells o The body fluid composition of tissue varies by: § Tissue type – lean tissues have higher fluid content than fat tissues § Gender – makes have more lean tissue and therefore more body fluid § Age – lean tissue is lost with age, and body fluid is lost with it. • Electrolytes o In intracellular fluid, potassium and HPO 42-are the predominant electrolytes o In extracellular fluid, Na and Cl predominate o There is a slight electrical charge difference on either side of the cell membrane • Functions of Fluids o Fluids dissolve and transport substances § Water is an excellent solvent because it can dissolve many different substances § The dissolved materials, or solutes, include ions, carbs, amino acids, vitamins, and minerals o Fluids account for blood volume § Blood volume is the amount of fluid in the blood § Increased blood volume can cause blood pressure to rise (hypertension) § Decreased blood volume can cause low blood pressure o Fluids help maintain body temperature § Because water has a high heat capacity, the temperature of our body fluids remain quite stable § Sweating releases heat as the evaporation of water from the skin cools the skin and blood o Fluid protect and lubricate our tissues § Cerebrospinal fluid protects the brain and spinal column § Amniotic fluid protects the fetus § Synovial fluid is a lubricant around joints § Digestive secretions allow for easy passage of material § Pleural fluid covering the lungs allows friction-free expansion and retraction • Functions of electrolytes o Electrolytes help regulate fluid balance § Water follows the movement of electrolytes, moving by osmosis to areas where the concentration of electrolytes is high § This allows for the controlled movement of fluids into and out of cells o Electrolytes enable our nerves to respond to stimuli § Movement of sodium and potassium across the membranes of nerve cells changes the electrical charge across the membrane § This change in electrical charge carries the nerve impulse along the nerve cell o Electrolytes signal our muscles to contract § The movement of calcium into a muscle cell stimulates the muscle to contract § The calcium is pumped back out of the cell after the muscle contraction • Maintaining fluid balance o Fluid balance is maintained by different mechanisms prompting us to drink and retain fluid o The thirst mechanism occurs from a cluster of nerve cells that stimulate our desire to drink o However, the thirst mechanism is not always sufficient; the amount of fluids people drink may not be enough to achieve fluid balance o Water lost from the body must be replaced o Water is lost through urine, sweat, evaporation, exhalation, and feces o Water is gained through beverages, food and metabolic reactions § Metabolic water contributes about 10-14% of the water the body needs o Loss of water § Sensible water loss occurs though urine and sweat • Most water is lost through urine • The kidneys control how much water is reabsorbed; excess water is processed by the kidneys and excreted as urine § Insensible water loss occurs through evaporation from the skin or exhalation from the lugs, as well as through feces § Diuretic increase fluid loss via the urine • Water o Function of water § Essential for life § Required for fluid and electrolyte balance and many metabolic reactions o Recommended intake § Varies with environment and activity level o Surface water comes from lakes, rivers, and reservoirs o Groundwater comes from underground rock formations called aquifers o “Hard water” is relatively high in calcium o The US environmental Protection Agency (EPA) sets and monitors standards for public water systems and is responsible for regulation of bottled water o What if you drink too much water? § Becoming overhydrated is rare § Con result in a dilution of sodium (hyponatremia) o What is you don’t drink enough water? § Dehydration § Infants and the elderly are especially vulnerable • Commercial beverages o Low-fat and skim milk provide protein, calcium, phosphorus, vitamin D, and usually, vitamin A o Moderate consumption of beverages with caffeine is safe and potentially healthful o Most soft drinks, juice drinks, flavored waters, ad bottled tea and coffee drinks are loaded with added sugars o “Designer waters” with added nutrients and/or herbs can add more than 300 Calories to the day’s intake and rarely contribute to better health o Many energy drinks, typically consumed quickly, contain a high amount of caffeine, which can cause a dramatic rise in blood pressure and heart rate § They also contain a significant amount of added sugar • Sodium o Functions of sodium § Fluid and electrolyte balance § Associated with blood pressure and pH balance in the body § Required for nerve impulse transmission § Assists in the transport of certain nutrients (e.g., glucose) into body cells o Recommended intake § 1.5 g/day is required § No more than 2.3 g/day is recommended o Sources of sodium § Processed foods and restaurant foods are generally high in sodium o What if you consume too much sodium? § Hypernatremia: abnormally high blood sodium concentration § Can occur in patients with congestive heart failure or kidney disease § Results in high blood volume, edema, and high blood pressure o What if you don’t consume enough sodium? § Hyponatremia: an abnormally low blood sodium level § Can result from prolonged vomiting, diarrhea, or sweating § Has been seen in marathon athletes who consume too much water and fail to replace sodium • Potassium o Functions of potassium § Fluid and electrolyte balance § Very important in muscle contractions and transmission of nerve impulses § High potassium intake helps to maintain a lower blood pressure o Recommended intake § 4.7 g/day o Sources of potassium § Processed foods are usually low in potassium § Fresh fruit and vegetables and whole grains are good sources of potassium o What if you consume too much potassium? § Hyperkalemia: a high blood potassium level § Can occur in patients with kidney disease § Can alter normal heart rhythm, resulting in a heart attack o What if you don’t’ consume enough potassium? § Hypokalemia: a low blood potassium level § Can be seen in patients with kidney disease or diabetic acidosis § Can occur when taking certain diuretic medications • Chloride o Functions of chloride § Assists with maintaining fluid balance § Assists the immune system § Component of HCl in the stomach o Recommended intake § Minimum recommendations is 2.3 g/day o What if you consume too much chloride? § May lead to hypertension in salt-sensitive patients o What if you don’t consume enough chloride? § This is rare but can occur in people with eating disorders • Phosphorus o Functions of phosphorus § The major intracellular negatively charged electrolyte § Required for fluid balance § Critical role in bone formation (85% of body’s phosphorus is found in bone) § Regulates biochemical pathways by activating or deactivating enzymes § Found in ATP, DNA, RNA o Recommended intake § RDA is 700 mg/day o Sources of phosphorus § Widespread in many foods § Found in high amounts in foods that contain protein (e.g., meat, milk, eggs) o What if you consume too much phosphorus? § High blood levels of phosphorus can occur with kidney disease or when taking too many vitamin D supplements § Causes muscle spasms, convulsions o What if you don’t consume enough phosphorus? § Deficiencies of phosphorus are rare • Fluid and electrolyte balance disorders o Serious health problems that can occur when fluid excretion exceeds intake include: § Dehydration § Heat illness • Dehydration o Dehydration occurs when water loss exceeds water intake § Commonly due to heavy exercise or high environmental temperatures § Infants and the elderly are more at risk o Other common causes of dehydration include § Diarrhea § Vomiting § Fever § Burns, including sunburn § Poorly controlled diabetes § Abuse of diuretics or laxatives o Dehydration is classified in terms of percentage of weight loss that is exclusively due to the loss of fluids • Heat illness o Three common types of heat illnesses closely linked to dehydration are: § Heat cramps § Heat exhaustion § Heatstroke • Heat cramps o Painful muscle cramps, usually in the abdomen, arms or legs o Develop during vigorous activity sessions in the heat o Spasms can last second or minutes o Important to stop activity immediately, cool down, and rest; cramps may signal a more serious problem • Heat exhaustion o Typically occurs from vigorous activity in heat o May develop after several days in high heat when fluids are inadequate o Symptoms include cramps, weakness, vomiting, dizziness, and elevated blood pressure and pulse o Must be treated promptly and aggressively to prevent heatstroke from developing • Heatstroke o Heatstroke occurs if the body’s temperature regulation mechanisms fail § Occurs in hot, humid environments § Symptoms include rapid pulse, hot and dry din, high body temperature, and weakness § Has been fatal for athletes during exercise in extreme heat § If it occurs, provide immediate cooling and rest, and contact emergency medical help quickly • In Depth: Alcohol o Alcohols are chemical compounds characterized by a hydroxyl group o In common usage, beverages containing ethanol made from fermented fruits, veggies, or grains o What is moderate alcohol intake? § A drink is defined as the amount of a beverage that provides ½ fluid ounce of pure alcohol § Proof is a measurement of alcohol content § Moderate alcohol intake is defined as the consumption of up to one drink per day for women, and up to two drinks per day for men o Benefits of moderate consumption include: § Stress and anxiety reduction § Appetite improvement § Lower rates of heart disease § Possible lower risks for diseases such as diabetes, heart disease, and liver disease o Concerns about moderate alcohol intake include: § Women appear to be at a higher risk for breast cancer § Increased risk for hypertension § Higher rates of bleeding in the brain § Relatively high Calorie content § Potential risk for adverse drug interactions o Types of alcohol abuse: § Alcohol abuse is excessive intake of alcohol § Binge drinking is consumption of five or more drinks per occasion § Alcoholism is a disease characterized by chronic dependence on alcohol o Effects of alcohol abuse: § A hangover is a consequence of drinking too much alcohol; symptoms include headache, fatigue, dizziness, muscle aches, and nausea § Even at low intakes, alcohol impairs reasoning and judgment § Alcohol poisoning is a potentially fatal metabolic state involving cardiac and respiratory failure § Alcohol abuse can lead to traumatic injury from falls, drowning, assaults, and traffic accidents § When the rate of alcohol intake exceeds the ability of the liver to break alcohol down, liver cells are damaged or destroyed • Fatty liver is an early but reversible sign of liver damage • Alcohol hepatitis results in loss of appetite, nausea and vomiting, abdominal pain and jaundice • Cirrhosis of the liver involves permanent scarring after years of alcohol abuse § Chronically high intake increases risk for: • Impaired bone health • Pancreatic injury and diabetes • Cancer • Abdominal obesity • Malnutrition o Fetal and infant health problems include: § Fetal alcohol syndrome (FAS), a set of serious, irreversible birth defects, including physical, emotional, behavioral, and developmental problems § Fetal alcohol effects (FAE), subtler consequences that may be exhibited later, including hyperactivity, attention deficit disorder, and impaired learning abilities o You should be concerned about your alcohol intake if you engage in binge drinking or drink at inappropriate times o Speak with a trusted friend, coach, teacher, counselor or healthcare provider
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