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Nove Mae R.

Escabarte BSN 3 - A
Keeping FIuids and EIectroIytes in BaIance
By: Christopher D. Jensen, PhD, MPH, RD

t's no surprise that fluid/electrolyte balance is critical to performance for
endurance athletes. After all, water is your #1 ingredient, and every cell and tissue in
your body bathes in it. The fluid that circulates throughout your body also includes
dissolved minerals known as electrolytes. These electrolytes help properly regulate the
fluid levels inside and between cells, and they're absolutely vital to the proper
functioning of your cells and tissues, including muscle tissue.

Dehydration
ronically, as an athlete, your fluid/electrolyte balance is challenged on an
everyday basis. During exercise, your muscles generate loads of internal heat that can
quickly build up and become toxic if not promptly released. Fortunately, your body cools
itself by sweating. But in the process, you lose the very fluids and electrolytes,
especially sodium that is essential to keeping you properly hydrated and cooled. Your
body can stand to lose a certain amount of sweat without your performance's being
affected; but at some point, that loss of fluid and sodium takes a toll. The dehydration
that can result forces your heart to work harder to keep up, your core body temperature
rises, and the exercise you're doing feels increasingly more difficult. As a result, your
athletic performance falls off dramatically. f allowed to progress, dehydration can also
have very serious health consequences.

Overhydration
f dehydration is at one end of the spectrum, overhydration is at the other end.
And the consequences, both athletically and healthwise, are on a par with dehydration.
Overhydration during exercise is caused by drinking more fluid than your body is losing
due to sweat. Too much fluid causes the electrolyte concentration in the body to
become overly diluted. Here again, sodium is a major player. f the sodium
concentration in the blood becomes too diluted, a condition known as hyponatremia, or
low blood sodium, develops. As with dehydration, in the early stages of overhydration,
athletic performance is hampered. f allowed to progress, there can be very serious
health consequences.



%he hydration zone
The key to avoiding both dehydration and overhydration is to stay in your
hydration zone. Your hydration zone is that level of hydration that enables you to
perform at your best. The high end of your hydration zone is your usual pre-exercise
body weight. n other words, you never want to consume so much fluid during exercise
that you actually end up gaining weight. And the threshold for fluid loss beyond which
performance is measurably hampered is 2% of your body weight. For example, if you
typically weigh 150 lbs (68 kg), 2% of your body weight is 3 lbs (1.4 kg). So your
hydration zone would be a high of 150 lbs (68 kg) and a low of 147 lbs (66.6 kg). f you
stay within that weight range during exercise, chances are good that you won't suffer a
fluid/electrolyte imbalance that would otherwise undermine your performance or health.

Having established the importance of the hydration zone and how to calculate it,
the next hurdle is staying in that zone when training and competing. That can be
challenging because your sense of thirst during exercising is a very poor gauge of your
fluid needs. t's well established that when athletes rely on thirst alone during endurance
exercise, they fall far short of meeting fluid needs, and dehydration is common. nstead,
what's required is a hydration plan.

ReIerence: hLLp//wwwpowerbarcom/arLlcles/319/keeplngfluldsandelecLrolyLeslnbalanceaspx











1|ps for Deve|op|ng our nydrat|on |an

Start hydrated lf you go lnLo workouLs fully hydraLed you'll be able Lo Lraln harder and reallze beLLer
galns 1he same goes for endurance compeLlLlons you'll be beLLer able Lo susLaln your race pace and
achleve LhaL personal besL Make up for any prevlously lncurred fluld deflclLs by consumlng 1420 fl oz
(400600 ml) of waLer or sporLs drlnk 23 hours before a compeLlLlon or Lralnlng sesslon keep
hydraLlng as needed prlor Lo a workouL or as you're warmlng up before a compeLlLlon especlally lf
condlLlons are hoL or humld

Check your hydrat|on status before exerc|se ?ou can monlLor your hydraLlon sLaLus before exerclse by
checklng Lhe color of your urlne A llghLyellow color ls conslsLenL wlLh adequaLe hydraLlon lf your urlne
ls darker more llke Lhe color of apple [ulce LhaL's Lyplcally a slgn LhaL more flulds are needed before you
sLarL exerclslng

know what to hydrate w|th WaLer ls usually flne for shorL workouLs or evenLs (eg less Lhan an hour)
ln mlld weaLher Powever for lnLense workouLs long compeLlLlons and anyLlme you're exerclslng ln Lhe
heaL and humldlLy a sporLs drlnk LhaL provldes carbohydraLes flulds and sodlum such as ower8ar
Lndurance sporLs drlnk ls a much beLLer opLlon Lhan plaln waLer 1he advanLages are many llrsL a
sporLs drlnk provldes carbohydraLes Lo help susLaln your blood glucose level durlng exerclse Second
aLhleLes Lyplcally consume more flulds when Lhelr hydraLlon beverage ls flavored as ls Lhe case wlLh a
sporLs drlnk 1hlrd Lhe sodlum and carbs ln a sporLs drlnk cause Lhe fluld ln Lhe beverage Lo be absorbed
more qulckly 1he sodlum also helps malnLaln your drlve Lo conLlnue drlnklng flulds durlng exerclse
whlch ls cruclal Lo meeLlng your fluld needs llnally Lhe sodlum also helps you reLaln Lhe fluld LhaL
you've consumed AnoLher opLlon for rehydraLlng and refuellng especlally ln longer Lralnlng sesslons or
evenLs ls Lo consume an energy gel and chase lL wlLh waLer Make sure Lo selecL an energy gel LhaL
provldes sodlum along wlLh carbohydraLes such as ower8ar Cel 1hese gels are deslgned Lo be
consumed every 2043 mlnuLes durlng exerclse and Lhey provlde Lhe sodlum and carbohydraLe slmllar
Lo LhaL of a sporLs drlnk

know how much to dr|nk As dlsLance LemperaLure or humldlLy lncreases Lhe need for flulds lncreases
as well 1o sLay hydraLed ln Lhese clrcumsLances you'll need Lo consume flulds aL a raLe LhaL keeps pace
wlLh your sweaL raLe so LhaL you don'L end up ouLslde of your hydraLlon zone 1hls generally requlres
abouL 1326 fl oz (400800 ml) every hour of exerclse lL's generally preferable Lo consume smaller
amounLs of fluld more frequenLly such as 37 fl oz (100200 ml) abouL every 13 mlnuLes 8uL keep ln
mlnd LhaL fluld needs can vary conslderably based on facLors such as body slze pace and weaLher
condlLlons 1herefore you may wanL Lo calculaLe your acLual sweaL raLe for Lhe varlous condlLlons ln
whlch you Lraln and compeLe CalculaLlng your sweaL raLe ls really qulLe slmple lor a sLepbysLep gulde
use Lhe ower8ar SweaL 8aLe CalculaLor aL ower8arcom

kehydrate dur|ng recovery CeL lnLo Lhe hablL of welghlng yourself before and afLer exerclse 1he
dlfference ln your welghL ls how much fluld you losL 8eplace Lhls fluld afLer exerclse by gradually
drlnklng 23 fl oz (690 ml) of a sporLs drlnk recovery beverage or waLer for every lb (1300 ml per kg) of
welghL losL Consume sodlum sources along wlLh your flulds as rehydraLlon wlll be more effecLlve when
sodlum ls lncluded wlLh Lhe fluld and food you consume as you recover lf you flnd LhaL your neL loss of
flulds conslsLenLly exceeds 2 of your body welghL Lry Lo bump up your fluld lnLake a blL durlng
exerclse lf you flnd LhaL you acLually galn welghL durlng a workouL or compeLlLlon cuL back a blL on
your raLe of fluld lnLake durlng exerclse

8y focuslng on your fluld/elecLrolyLe balance before durlng and afLer exerclse you can hydraLe more
effecLlvely and remaln wlLhln your hydraLlon zone And LhaL LranslaLes Lo beLLer workouLs sLronger
performances and fasLer recovery
hLLp//wwwpowerbarcom/arLlcles/319/keeplngfluldsandelecLrolyLeslnbalanceaspx














Nove Mae R. Escabarte BSN 3 A
Hematuria

Hematuria refers to blood in the urine. Often, if a child complains of painful urination or
abdominal pain, his doctor may want to test the child's urine using a paper test strip. This is
known as a dipstick urinalysis. One of the tests that can be performed with these test strips is a
test for blood. Sometimes the blood is obvious like a clot and this is called gross hematuria. t is
important to always test the urine even when it appears red because not all obviously red urine
has blood in it. For example, certain foods like beets and certain medicines like metronidazole
(an antibiotic) can make the urine turn red.
Other times the amount of blood is invisible to the naked eye and is called
microscopic hematuria. Microscopic hematuria without other symptoms, such as edema
or swelling, high blood pressure, renal insufficiency or proteinuria (protein in the urine),
is very common and occurs in almost 2% of children. Since it is so common, your
Pediatrician may just repeat the urine test in a few weeks or months to see if it goes
away on its own (unless the hematuria is gross or your child has other symptoms or
clinical findings).
n either case, whether microscopic or gross, there are a lot of reasons why a
person can get blood in her urine. n addition to a microscopic examination of the urine
as described below, other tests may include a complete blood count (CBC), a urine
culture, a serum creatinine level (which is a test of how well the kidney is working), a
serum C3 level, and a urine test for the level of protein, calcium and creatinine (this
urine test may be a 'spot' test on a sample of urine or it may be on a 24 hour urine
collection). Further testing depends on what other symptoms a child has and may
include further blood tests, a voiding cystourethrogram (VCUG), renal sonogram,
cystoscopy, and sometimes a biopsy of the kidney.
One of the most common causes of hematuria is a urinary tract infection or UT.
A culture of the urine to look for bacteria will determine if that is the cause. Other
common but harmless conditions are irritation of the urethra, the opening where the
urine comes out. Masturbation is another reason. nsertion of a foreign body into the
urethra like a catheter and trauma (sometimes minor) are other reasons. Menstrual
bleeding should be considered in young girls who have entered puberty. n these
conditions sometimes the blood is visible to the naked eye and sometimes it is not.
Also, exercise can sometimes cause hematuria and your doctor may test for this by
getting a first voided sample in the morning before your child has gotten out of bed.
f the cause of the bleeding is not easily identified, further examination of the
urine with a microscope can help sort out the cause. Under the microscope, if the
laboratory technician sees whole red blood cells (RBCs) without any distortion of their
shape and no clumps of RBCs (called casts), then the cause of the bleeding is from
somewhere in the urinary tract outside the kidneys themselves, such as the ureters (the
tubes that carry urine from the kidney to the bladder), the bladder or the urethra. Other
causes can be kidney stones and excessive calcium and cysteine (an amino acid) in the
urine. Doctors can check for kidney stones with an x-ray of the abdomen known as a
KUB (which stands for kidneys, ureters, and bladder). They can also determine the
amount of calcium and cysteine in the urine by requesting special chemical analyses of
the urine. Finally, a sonogram of the kidneys can be helpful to determine if there are any
malformations of the kidneys, cysts (fluid filled sacs within the kidney) or tumors that
may be the cause of the hematuria.
f the microscopic examination of the urine reveals both misshapen RBCs and
casts, then the bleeding is said to be glomerular, or from the kidney. A glomerulus is the
filtering body within the kidney. One of the most common causes of this kind of bleeding
is post-streptococcal glomerulonephritis. After an infection with some strains of Group A
Streptococcus (Streptococcus pyogenes), the bacteria that causes strep throat, the
body can develop an immune reaction that causes damages to the glomerular bodies.
These strains of streptococcus do not infect the kidney but can infect the throat and the
skin. Even if the throat or skin infection was treated with antibiotics, these strains of
bacteria can still can an immune reaction that temporarily damages the kidneys. The
reaction usually shows up one to three weeks after the throat or skin infection. Other
causes of hematuria that result in both RBC casts and misshapen RBCs are Henoch-
Schonlein purpura, hemolytic-uremic syndrome, Alport syndrome, and a host of other
conditions. These conditions are associated with protein in the urine (proteinuria) as
well as hematuria.
Finally microscopic examination of the urine can reveal no RBC casts and few to
no intact RBCs. This result is consistent with hemoglobinuria or myoglobinuria.
Hemoglobinuria means there is hemoglobin, the protein found in RBCs that gives the
red coloring. Myoglobinuria means there is myoglobin, the protein found in muscles.
When RBCs or muscle breakdown, these proteins are released into the blood stream
where they can then be filtered by the kidneys and go into the urine. Therefore any
condition that can cause destruction of red blood cells or muscles can lead to either
hemoglobinuria or myoglobinuria.
t is important to remember that there are usually other symptoms associated
with the most serious causes of hematuria, such as swelling or edema and/or high
blood pressure.
The cause of hematuria usually can be identified from the information the patient
(or in the case of children, their parents or caregivers) supply the doctor as well as the
physical exam and urinalysis. n about ten to twenty percent of cases, the cause
remains unknown and the patient is followed at regular intervals.
http://www.keepkidsheaIthy.com/weIcome/conditions/hematuria.htmI


Nove Mae R. Escabarte BSN 3 A

Factors influencing the restoration of fluid and electrolyte balance
after exercise in the heat.

Maintenance of fluid balance is a major concern for all athletes competing in
events held in hot climates. This paper reviews recent work relating to optimization of
fluid replacement after sweat loss induced by exercising in the heat. Data are taken
from studies undertaken in our laboratory. ssues investigated were drink composition,
volume consumed, effects of consuming food with a drink, effects of alcohol in
rehydration effectiveness, voluntary intake of fluid, and considerations for women
related to the menstrual cycle. The results are presented as a series of summaries of
experiments, followed by a discussion of the implications. The focus of this review is
urine output after ingestion of a drink; fluid excreted in urine counteracts rehydration.
Also included are data on the restoration of plasma volume losses. ngestion of large
volumes of plain water will inhibit thirst and will also promote a diuretic response. f
effective rehydration is to be maintained for some hours after fluid ingestion, drinks
should contain moderately high levels of sodium (perhaps as much as 50-60 mmol/l)
and possibly also some potassium to replace losses in the sweat. To surmount ongoing
obligatory urine losses, the volume consumed should be greater than the volume of
sweat lost. Palatability of drinks is important in stimulating intake and ensuring adequate
volume replacement. Where opportunities allow, the electrolytes required may be
ingested as solid food consumed with a drink. There are no special concerns for women
related to changes in hormone levels associated with the menstrual cycle. ngestion of
carbohydrate-electrolyte drinks in the post-exercise period restores exercise capacity
more effectively than plain water. The effects on performance of an uncorrected fluid
deficit should persuade all athletes to attempt to remain fully hydrated at all times, and
the aim should be to start each bout of exercise in a fluid replete state. This will only be
achieved if a volume of fluid in excess of the sweat loss is ingested together with
sufficient electrolytes.
ReIerence: http://bjsm.bmj.com/content/31/3/175.abstract




lnvLn1C8 and nA1lCnALl1? lnvLn1lCn and uSACL ?LA8 lnvLn1Lu
1 Daniel Dingel
Water-Powered Car
a car reactor that uses electricity from a
12-volt car battery to split the ordinary
tap water into hydrogen and oxygen
components. The hydrogen can then be
used to power the car engine.
1969
2 Edgardo Vazquez
odular Housing
$uch a system called Vazbuilt is
reportedly capable of building within
weeks a house with prefabricated
materials that can withstand typhoons
and earthquakes.
1995
3 Rudy Lantano $r.
nventor of Fuel Products :
Super Bunker Formula-L, a
revolutionary fuel half-composed of
water. The mix burns faster and emits
pollutants, 95 percent less than those
released to the air by traditional fuel
products.
1996
4 Rolando dela Cruz
ole Remover
an ingenuous formula that could easily
remove deeply grown moles or warts
from the skin without leaving marks or
hurting the patient. His formula was
extracted from cashew nut (Annacardium
occidentale), which is common in the
Philippines.
2000
38oberLo del 8osarlo
araoke Sing Along System
a handy multi-purpose compact machine
which incorporates an amplifier speaker,
one or two tape mechanisms, optional
tuner or radio and microphone mixer with
features to enhance one's voice.
1973
6Lduardo San !uan
Lunar Rover, or commonly known as
oon Buggy
A vehicle which could operate beyond
earths atmosphere, using homemade
materials. It was used by nell ArmsLrong along
wlLh oLher asLronauLs durlng Lhelr [ourney Lo Lhe
moon
1969
7 le del Mundo
ncubator and jaundice relieving
device
A more improved incubator
1941
8AgaplLo llores
Fluorescent Lamp
the most widely used source of lighting in
the world today.
1832
9 ur Abelardo Agullar
rythromycin
an alternative to penicillin
1949



10 ur vlrglllo Malang
Psidium Guajava ffervescing
Gynecological nsert, ternal
vaginal cleanser
eminine Hygiene Product
2002