Week 9 Water & Electrolytes PDF

WATER & ELECTROLYTES FN 1070 WEEK 9 – CHAPTER 11  WATER ESSENTIAL NUTRIENT MORE IMPORTANT TO LIFE THAN OTHER NUTRIENTS CAN ONLY SURVIVE A FEW DAYS WITHOUT WATER WATER IS INCOMPRESSIBLE, WHICH MEANS THAT THE MOLECULES ARE NOT CROWDED WATER MAKE...

WATER & ELECTROLYTES FN 1070 WEEK 9 – CHAPTER 11  WATER ESSENTIAL NUTRIENT MORE IMPORTANT TO LIFE THAN OTHER NUTRIENTS CAN ONLY SURVIVE A FEW DAYS WITHOUT WATER WATER IS INCOMPRESSIBLE, WHICH MEANS THAT THE MOLECULES ARE NOT CROWDED WATER MAKES UP ≈60% OF A PERSON’S BODY WEIGHT GREATER % IN CHILDREN BODY COMPOSITION PROPORTION OF WATER SMALLER IN FEMALES, OBESITY, OLDER ADULTS WATER IS FOUND IN BLOOD VESSELS CELLS TISSUES ́ORGANS  WATER IN THE BODY TRANSPORT VEHICLE BRINGS NUTRIENTS TO THE CELLS CLEANSING AGENT CARRIES WASTES PRODUCTS AWAY FROM CELLS MAINTAINS STRUCTURE OF LARGE MOLECULES PROTEINS, GLYCOGEN SERVES AS A SOLVENT FOR MINERALS, VITAMINS, AA, GLUCOSE, ETC. ALLOWING PARTICIPATION IN METABOLIC ACTIVITIES ACTIVELY PARTICIPATES IN MANY REACTIONS HELPS MAINTAIN BODY TEMPERATURE (SWEAT)  WATER IN THE BODY ACTS AS LUBRICANT & CUSHION FOR JOINTS LUBRICATES DIGESTIVE & RESPIRATORY TRACTS & MUCUS LININGS PROTECTS SPINAL CORD & FETUS FROM SHOCK KEEPS OPTIMAL PRESSURE ON EYE RETINA & LENS MAINTAINS THE BLOOD VOLUME  DISTRIBUTION & MOVEMENT OF BODY FLUIDS TYPE OF FLUIDS: INTRACELLULAR FLUID EXTRACELLULAR FLUID INTERSTITIAL FLUID INTRAVASCULAR FLUID COMPOSITION: DIFFERS AMONG THE TYPE OF FLUID EACH FLUID TYPE REMAINS CONSISTENT IN NORMAL CONDITIONS, CONTINUOUSLY LOSES AND REPLACES COMPONENTS  WATER INTAKE REGULATED BY THE BRAIN INFLUENCED BY THIRST AND SATIETY IN RESPONSE TO CHANGES SENSED BY: MOUTH, NERVES, HYPOTHALAMUS INADEQUATE WATER INTAKE: CONCENTRATED BLOOD DRY MOUTH HYPOTHALAMUS SIGNALS TO DRINK WATER EXCESSIVE WATER INTAKE: STOMACH EXPANDS STRETCH RECEPTORS SIGNAL TO STOP DRINKING  WATER BALANCE INTAKE: REGULATED BY THE BRAIN EXCRETION : REGULATED BY THE BRAIN & KIDNEYS LIQUIDS – WATER ITSELF AND OTHER BEVERAGES SWEAT (~30%) URINE (~35-50%) PROVIDE ~550-1500ML/DAY BREATH (~1.5) FOODS FECES (~7%) PROVIDE ~700-1000ML/DAY AMOUNT OF EXCRETION VARIES... WATER CONTENT VARIES: OBLIGATORY WATER EXCRETION: FRUITS/VEGETABLES (~90%), ENOUGH TO CARRY AWAY WASTES (ABOUT 2 CUPS PER DAY) MEATS/CHEESE (~50%) THE REST VARIES PERSON TO METABOLIC WATER PERSON AND DAY TO DAY BASED PROVIDES ABOUT ~10% ON INTAKE TO MAINTAIN BALANCE  HOW MUCH WATER DO I NEED TO DRINK IN A DAY? MANY FORMULAS USED TO DETERMINE THIS E.G: 1.0-1.5ML/KCAL/DAY (ADULTS) 1.5ML/KCAL (INFANTS AND ATHLETES) ADEQUATE INTAKE (DRI): MEN: 3.7 LITRES OF FLUID FROM BEVERAGES AND DRINKING WATER WOMEN: 2.7 LITRES OF FLUID FROM BEVERAGES AND DRINKING WATER WHO MIGHT NEED MORE THAN THIS? MOST OF THE REMAINING WATER WE NEED IS MET FROM CONSUMED FOODS  FACTORS THAT INCREASE WATER NEEDS: ALCOHOL OR CAFFEINE CONSUMPTION COLD/HOT WEATHER, DRY/HEATED ENVIRONMENTS DIABETES, DIURETICS, KIDNEY DISEASE* DIETARY FIBER, PROTEIN, SALT, AND SUGAR INTAKE EXERCISE FORCED AIR ENVIRONMENTS – AIRPLANES, SEALED BUILDINGS HIGH ALTITUDE PREGNANCY & BREASTFEEDING; YOUNG OR OLD PROLONGED DIARRHEA, VOMITING OR FEVER SURGERY, BLOOD LOSS, BURNS, KETOSIS  TYPE OF WATER HARD CA & MG LEAVES A RING ON THE TUB SOFT K & NA MAKES MORE BUBBLES WITH LESS SOAP SOME PEOPLE PURCHASE WATER SOFTENERS TO REMOVE CA AND MG AND REPLACE WITH NA POTENTIAL HEALTH IMPLICATIONS FOR CONSUMPTION WITH HTN/CVD MINERALS IN HARD WATER MAY BENEFIT THESE CONDITIONS BOTTLED WATER MANY PEOPLE CHOOSE THIS, HOWEVER TAP WATER IS TESTED REGULARLY AND IS GENERALLY SAFE FOR CONSUMPTION  TYPE OF WATER CARBONATED WATER CONTAINS C02 (NATURALLY OR ADDED) TO CREATE BUBBLES DISTILLED WATER VAPORIZED FREE OF DISSOLVED MINERALS MINERAL WATER FROM A SPRING OR WELL CONTAIN NATURAL MINERALS OFTEN HIGH IN SODIUM PUBLIC WATER FROM MUNICIPAL WATER SYSTEM TREATED AND DISINFECTED  BLOOD VOLUME & BLOOD PRESSURE KIDNEYS ARE RESPONSIBLE FOR ADJUSTING URINE VOLUME AND CONCENTRATION. SIGNALS TO RETAIN OR RELEASE FLUIDS AND SUBSTANCES COME FROM: RENIN ANGIOTENSIN ALDOSTERONE ANTIDIURETIC HORMONE (ADH)  BLOOD VOLUME/PRESSURE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (RAAS) RENIN: ENZYME RELEASED BY THE KIDNEY CELLS WHEN… BLOOD PRESSURE IS TOO LOW; CAUSES SODIUM TO BE REABSORBED AND WATER TO BE RETAINED ANGIOTENSINOGEN: PROTEIN IN THE LIVER CONVERTED TO ANGIOTENSIN I BY RENIN (INACTIVE FORM), AND ACTIVATED BY ANOTHER ENZYME TO ANGIOTENSIN II (VASOCONSTRICTOR) – RAISES BLOOD PRESSURE  BLOOD VOLUME/PRESSURE RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (RAAS) ALDOSTERONE: RELEASED FROM THE ADRENAL GLANDS TO… SIGNAL THE KIDNEYS TO EXCRETE POTASSIUM AND RETAIN SODIUM (AND WATER TOO) ADH: RELEASED FROM THE PITUITARY GLAND IF… EXTRACELLULAR FLUID IS TOO HIGH BLOOD PRESSURE OR BLOOD VOLUME IS TOO LOW STIMULATES THE KIDNEYS TO REABSORB MORE WATER  FLUID & ELECTROLYTE BALANCE 2/3 OF FLUID REMAINS INSIDE THE CELL AND 1/3 OUTSIDE THE CELL IMBALANCE MAY CAUSE CELL RUPTURE OR CELL COLLAPSE MAJOR MINERALS CONTROL MOVEMENT OF WATER NA, CL, K, CA, MG, P, S ELECTROLYTES: SALTS THAT DISSOCIATE INTO IONS (E.G: NA AND CL) IONS ARE POSITIVELY AND NEGATIVELY CHARGED PARTICLES NA+ CL- ANION: NEGATIVELY CHARGED (CL) CATION: POSITIVELY CHARGED (NA) MAINTAINING BALANCE: IF A CATION ENTERS A CELL, AN ANION MUST ACCOMPANY IT, OR ALTERNATELY ANOTHER CATION MUST LEAVE ELECTROLYTES ATTRACT WATER ALLOW SALTS TO DISSOLVE IN WATER MOVES FLUID INTO APPROPRIATE COMPARTMENTS CELL MEMBRANES SELECTIVELY PERMEABLE ALLOWING PASSAGE OF SOME MOLECULES AND RESTRICTING PASSAGE OF OTHERS MOVEMENT OF WATER OSMOSIS: MOVEMENT OF WATER TOWARD MORE CONCENTRATED SOLUTE OSMOTIC PRESSURE: PRESSURE NEEDED TO PREVENT MOVEMENT OF WATER ACROSS A MEMBRANE  REGULATION OF FLUID & ELECTROLYTE BALANCE AMOUNT OF MINERALS IN THE BODY MUST REMAIN CONSTANT REGULATION OCCURS AT: GI TRACT MINERALS FROM FOOD AND FROM DIGESTIVE JUICES ARE REABSORBED AS NEEDED IN THE LARGE INTESTINE KIDNEYS REGULATE ELECTROLYTE CONTENT BY RESPONDING TO ALDOSTERONE (HORMONE) LOW SODIUM à ALDOSTERONE STIMULATES KIDNEYS TO REABSORB SODIUM POTASSIUM MAY BE EXCRETED AS MORE SODIUM REABSORBED TO MAINTAIN BALANCE BETWEEN POSITIVE AND NEGATIVE CHARGES  FLUID & ELECTROLYTE IMBALANCE CONTRIBUTING FACTORS MEDICATIONS ILLNESSES/DISEASE STATES DIFFERENT SOLUTES (GLUCOSE, NA, K) ARE LOST DEPENDING ON THE REASON FOR FLUID LOSS à HOWEVER, THEY ALL RESULT IN DEHYDRATION! WATER ALONE DOES NOT RESTORE ELECTROLYTE BALANCE FOR SEVERE CASES MAY NEED ORAL REHYDRATION SOLUTIONS (MAY CONTAIN VARYING AMOUNTS OF NA, GLUCOSE, WATER ETC) SODIUM  SODIUM CHIEF ION OUTSIDE OF THE CELLS (EXTRACELLULAR ION) FUNCTIONS – TOGETHER WITH CHLORIDE AND POTASSIUM MAINTAINS CELL’S FLUID BALANCE MAINTAINS CELL’S ACID-BASE BALANCE ESSENTIAL TO MUSCLE CONTRACTION AND NERVE IMPULSE TRANSMISSION ABSORBED IN THE GI TRACT FILTERED IN THE KIDNEYS  SODIUM RECOMMENDATIONS AI 1500 MG/DAY (19–50 YR) 1300 MG/DAY (51–70 YR) 1200 MG/DAY (>70 YR) CHRONIC DISEASE RISK REDUCTION 2300 MG/DAY  SODIUM & HYPERTENSION (HTN) HIGH SALT INTAKE (NACL) CORRELATES WITH INCREASED RISK FOR ELEVATED BLOOD PRESSURE (HTN) INCREASED FAST FOOD/PROCESSED FOOD = INCREASED INTAKE DECREASING SODIUM INTAKE REMAINS A PUBLIC HEALTH PRIORITY FOR CANADA  STRATEGIES TO CONTROL SALT INTAKE LIMIT INTAKE OF: SAUCES, ADDED SALTS CONTROL THE SALT SHAKER TASTE FOOD BEFORE ADDING DECREASE INTAKE OF PROCESSED FOODS INCREASE INTAKE OF: UNPROCESSED WHOLE FOODS USE SPICES TO SEASON/FLAVOUR FOOD: MEAT/POULTRY/FISH – DILL, LEMON, TARRAGON, PARSLEY, GARLIC, THYME VEGETABLES – BASIL, DILL, MARJORAM, MINT, THYME, PEPPER READ LABELS  DASH DIET (DIETARY APPROACHES TO STOP HYPERTENSION) DIETARY PATTERN TO HELP PREVENT OR TREAT HIGH BLOOD PRESSURE SIMILAR TO CFG FOCUSES ON INCLUSION OF FRUITS/VEGETABLES, WHOLE GRAINS, LEAN MEATS, PLANT-BASED PROTEIN SOURCES, LOWER FAT DAIRY PRODUCTS *CONSUME FOODS HIGH IN K, MG, CA  SODIUM IN FOODS Salt added in processing Naturally occuring Added at home THE EFFECT OF PROCESSING  SODIUM DEFICIENCY HUMAN DIET DOES NOT LACK SODIUM CAUSES: VOMITING, DIARRHEA, SWEATING RESULTS IN LOSSES OF WATER AND NA CAN BE REPLACED WITH FOOD AND FLUID HYPONATREMIA DECREASED SODIUM IN THE BLOOD CAN RESULT FROM NA LOSSES AND EXCESS WATER INTAKE NOTE: CAUSED BY EXCESSIVE SODIUM LOSSES NOT INADEQUATE INTAKE SYMPTOMS: HEADACHE, CONFUSION, SEIZURES, COMA  SODIUM TOXICITY NO UL UNABLE TO SEPARATE NA TOXICITY FROM RISK OF CHRONIC DISEASE CDRR = 2300MG SYMPTOMS: EDEMA ACUTE HYPERTENSION CHLORIDE  CHLORIDE MAJOR NEGATIVE ION (ANION) IN THE BODY EXTRACELLULAR (ACCOMPANIES NA) MOVES PASSIVELY ACROSS MEMBRANES INSIDE THE CELL PAIRS WITH K MAINTAINS FLUID & ELECTROLYTE BALANCE AND ACID-BASE BALANCE IN THE STOMACH PART OF HCL TO MAINTAIN STRONG ACIDITY OF GASTRIC JUICES VOMITING LEADS TO LOSS OF HCL AND DISRUPTION OF ACID-BASE BALANCE  RECOMMENDATIONS AND INTAKES AI: ADULTS 2300MG/DAY (19-50 YR) 2000MG/DAY (51-70 YR) 1800MG/DAY (>70 YR) UL: ADULTS 3600MG/DAY  SOURCES OF CHLORIDE FOUND ABUNDANTLY IN FOODS AS PART OF SALTS (NACL): SALT, SOY SAUCE, ULTRA PROCESSED FOODS MODERATE AMOUNT IN MEAT, EGGS, MILK  CHLORIDE DEFICIENCY AND TOXICITY DEFICIENCY: DIET RARELY LACKS ADEQUATE AMOUNTS, THEREFORE DEFICIENCY IS RARE LOSSES WITH CHRONIC DIARRHEA, HEAVY SWEATING, VOMITING TOXICITY: HIGH BLOOD LEVELS D/T DEHYDRATION BALANCE CAN BE RESTORED WITH REGULAR FOOD/FLUID INTAKE SYMPTOMS: VOMITING POTASSIUM  POTASSIUM POSITIVELY CHARGED ION (LIKE NA) PRINCIPLE INTRACELLULAR ION MAINTAIN FLUID AND ELECTROLYTE BALANCE MAINTAINS CELL INTEGRITY BALANCE IS CRITICAL TO MAINTAINING HEARTBEAT FACILITATES MANY REACTIONS, NERVE IMPULSE TRANSMISSION, MUSCLES CONTRACTIONS  RECOMMENDATIONS & INTAKES ABUNDANT IN ALL LIVING CELLS AI: 2600MG/DAY (WOMEN), 3400MG/DAY (MEN) POTASSIUM & HTN: SUPPORTS HEALTHY BLOOD PRESSURE DASH DIET  SOURCES OF POTASSIUM: FRESH FOODS - MOSTLY FRUITS/VEGETABLES ALSO FOUND IN: GRAINS DAIRY PRODUCTS LENTILS MEAT AND FISH  POTASSIUM DEFICIENCY & TOXICITY DEFICIENCY: INCREASED BLOOD PRESSURE, KIDNEY STONES, BONE TURNOVER SYMPTOMS: IRREGULAR HEARTBEAT, MUSCLE WEAKNESS, GLUCOSE INTOLERANCE TOXICITY: NO UL AS IT DOES NOT RESULT FROM OVERCONSUMPTION OF HIGH K FOODS RESULTS FROM OVERCONSUMPTION OF CERTAIN SALTS OR SUPPLEMENTS OR CERTAIN DISEASES OR TREATMENTS INCREASE K = INCREASE K EXCRETION BY THE KIDNEYS K DIRECTLY INJECTED INTO A VEIN = HEART STOPS! SYMPTOMS: MUSCULAR WEAKNESS, VOMITING PHOSPHORUS  PHOSPHORUS SECOND MOST ABUNDANT MINERAL IN THE BODY (AFTER CALCIUM) ~85% FOUND BOUND WITH CALCIUM IN BONES/TEETH MAJOR NEGATIVELY CHARGED ELECTROLYTE FOUND INSIDE CELLS P + K HELP TO MAINTAIN FLUID BALANCE IN THE BODY ACTS AS PART OF A BUFFER SYSTEM (MAINTAIN ACID-BASE BALANCE) REQUIRED FOR GROWTH (PART OF DNA AND RNA) PART OF CELL MEMBRANES AND LIPOPROTEINS ASSISTS IN ENERGY METABOLISM (ATP) ASSISTS ENZYMES AND VITAMINS FROM EXTRACTING ENERGY FROM NUTRIENTS  RECOMMENDATIONS & INTAKES RDA: 700MG PER DAY (ADULTS) UL: 4000MG PER DAY (ADULTS)  SOURCES OF PHOSPHORUS PROTEIN RICH FOODS MEAT, FISH, POULTRY, LEGUMES, NUTS, MILK AND MILK PRODUCTS MILK AND CHEESE CONTRIBUTE ~25% OF PHOSPHORUS IN NORTH AMERICAN DIET  DEFICIENCY & TOXICITY DEFICIENCY: NOT VERY COMMON IN HEALTHY INDIVIDUALS SYMPTOMS IF IT WERE TO OCCUR: MUSCULAR WEAKNESS, BONE PAIN TOXICITY: NOT COMMON IN HEALTHY INDIVIDUALS SYMPTOMS IF IT WERE TO OCCUR: CALCIFICATION OF NON-SKELETAL TISSUES (IN THE KIDNEYS)  DEHYDRATION Thirst Weakness Exhaustion Delirium Death  DEHYDRATION CAUSES: 1. DIARRHEA TREATMENT DEPENDS ON THE CAUSE – GOAL TO REPLENISH LOST WATER AND ELECTROLYTES PROMPT TREATMENT FOR CHILDREN AND OLDER ADULTS 2. VOMITING TREATMENT DEPENDS ON CAUSE LOSSES OF WATER AND NA IN SEVERE CASES 3. FEVER LOSSES THROUGH THE SKIN D/T HEAVY SWEATING 4. UNCONTROLLED DIABETES ELEVATED BLOOD GLUCOSE CAN LEAD TO INCREASED THIRST AND URINATION 5. MEDICATIONS DIURETICS AND LAXATIVES  THIRST Decreased fluid Thirst signals can be Be proactive intake or increased ignored losses Stimulates thirst Not having a Don’t wait until mechanism in the drink nearby you are thirsty brain Distracted with Drink throughout other activities the day Body then starts If ignore early to conserve water signs of dehydration, have result in more severe symptoms  HEAT ILLNESSES HEAT CRAMPS: RESULTS FROM WORKING OUTSIDE IN HOT CONDITIONS CAUSED BY WATER AND NA LOSSES FROM MUSCLES SYMPTOMS: SMALL MUSCLE TWITCHES IN ARMS, LEGS OR ABDOMEN à PAINFUL MUSCLE SPASMS TREATMENT: DRINK JUICE, SPORTS DRINK OR WATER + PINCH OF SALT MOVE TO A COOL PLACE, STOP ALL ACTIVITY  HEAT ILLNESSES HEAT EXHAUSTION: EXERTIONAL ACTIVITY IN HOT CONDITIONS EXCESSIVE SWEATING IN ATTEMPT TO COOL THE BODY (NA AND WATER LOSSES) INCREASED BODY HEAT PRODUCTION, LESS WATER TO STABILIZE BODY TEMP LOSS OF CONSCIOUSNESS OR HEAT COLLAPSE POSSIBLE SYMPTOMS: HEADACHE, NAUSEA, VERTIGO, WEAKNESS, RAPID BREATHING, THIRST TREATMENT: MOVE TO A COOL PLACE CONSUME A COOL BEVERAGE (SPORTS BEVERAGE) REMOVE SPORTING EQUIPMENT (HELMET, LOOSEN CLOTHES) TO HELP BODY TO COOL COOL SHOWER, COLD COMPRESS (NECK/UNDER ARMS)  HEAT ILLNESSES HEAT STROKE: OVEREXERTION IN HOT CONDITIONS (WORK OF PHYSICAL ACTIVITY) + LOW BODY WATER + ELECTROLYTE IMBALANCE BODY CANNOT REGULAR IT’S TEMPERATURE REQUIRES IMMEDIATE MEDICAL ASSISTANCE SWEATING STOPS D/T LOW BODY RESERVES OF WATER AND CORE TEMPERATURE RISES QUICKLY SYMPTOMS: WEAKNESS, NAUSEA, RAPID PULSE, HYPERVENTILATE, MENTAL DISORIENTATION, HEADACHE, MAY LOSE CONSCIOUSNESS/HAVE CONVULSIONS TREATMENT: CALL 911 AND FOLLOW DIRECTIONS  WATER INTOXICATION RARE EXCESSIVE WATER INGESTION AND SOME KIDNEY DISORDERS IMPACTING EXCRETION 10-20L WITHIN A FEW HOURS DILUTES SODIUM CONCENTRATION OF THE BLOOD = HYPONATREMIA SIGNS: CONFUSION CONVULSIONS HEADACHE MUSCULAR WEAKNESS POOR MEMORY