Karen is a 66-year-old grandmother of five. She worked in an office as a legal secretary for many years before recently retiring. Due to her job and busy lifestyle, she often skipped breakfast and relied on coffee to see her through to lunch, which she usually bought from one of the food trucks outside her office building. Her favorite lunch was a sliced pork sandwich and pickle from the deli meat truck. She continued drinking coffee into the afternoon, and then sometimes at home after dinner. Despite her retirement, her dietary practices remain essentially the same, except that she buys meats from the grocery store and makes her own sandwiches now. Karen rarely ever drinks plain water, herbal tea, juice, or milk-black coffee and red wine are her only sources of hydration. For many years, Karen has battled kidney stones, high blood pressure, headaches, and chronic fatigue. How have Karen's dietary habits contributed to her health issues and what changes should she make to her routine?
1. Although Karen drinks a moderate amount of fluid each day, all of it (except the wine) contains caffeine-a diuretic that stimulates the body to urinate. Assuming that Karen is getting enough fluid to offset coffee's diuretic effect, what potential conditions related to chronically low fluid intake levels (dehydration) might she need to be aware of?
a. atherosclerosis, hypotension, and migraines
b. glaucoma, cataracts, and night blindness
c. heart attack, stroke, and diabetes
d. kidney stones, hypertension, and constipation
e. gallstones, urinary tract infections, and diabetes