Ch. 19 - Fluid Therapy

Front 1

Body water is distributed among three types of compartments:

Back 1

1. intracellular (in the cells)

2. intravascular (in the vessels)

3. interstitial (in the tissue)

Front 2

Most body fluids are located in the:

Back 2

cell membrane (intracellular)

Front 3

Examples of extracellular fluid (intravascular and interstitial) (3)

Back 3

vitreous humor

aqueous humor

cerebrospinal fluid

Front 4

Another word for electrolytes:

Back 4

ions

Electrolytes are substances that split into ions when placed in water

Front 5

What are the primary ions in the body: (5)

Back 5

1. sodium

2. chloride

3. potassium

4. phosphate

5. bicarbonate

Front 6

Cations have what type of charge?

Anions have what type of charge?

Back 6

Cations = positive

Anions = negative

Front 7

Examples of cations:

Examples of anions:

Back 7

cations: Ca+, K+

anions: Cl-

Front 8

Extracellular fluid shifts between which two spaces in order to maintain a fluid balance with the ECF compartment?

Back 8

interstitial

intervascular

Front 9

Fluid therapy in animals commonly involves the use of what two types of fluids?

Back 9

1. crystalloid

2. colloid

Front 10

___________________ are diffusible substances that dissolve in solution.

_________________ are non-diffusible substances.

Back 10

1. crystalloids

2. colloids

Front 11

Name an example of a colloid:

Back 11

plasma

Front 12

How do colloids help to keep BP up?

Back 12

Colloids stay in the body - they are not rapidly lost through urination the way crystalloids are.

Front 13

Can crystalloids increase BP?

Back 13

Yes, but only for a short amount of time because they are urinated out.

Front 14

What is the general rule (calculation) for administering fluids?

Back 14

1mL / lb / hr

Front 15

The basis for fluid therapy depends on the animal's _____________ status.

Back 15

hydration

Front 16

Fluid therapy can replace what 4 things?

And can restore what?

Back 16

Replace:

1. sodium

2. potassium

3. chloride electrolytes

Restore:

hydrogen ion balance (pH balance)

Front 17

Fluid Administration:

Intraperitoneal fluids:

When are they given?

What is significant about the injection site?

Back 17

Given when IV access is not available

Injection site must be asceptic

Front 18

Disadvantages of intraperitoneal fluid administration: (3)

Back 18

1. risk of sepsis

2. can't use IP routes in animals having abdominal surgery

(all that fluid sloshing around in there, interferes with surgery)

3. inability to use hypertonic solutions

Front 19

Why can't we use hypertonic solutions when administering intraperitoneal fluids?

Back 19

Hypertonic solutions will draw fluid OUT of the cells...

Therefore they will dry out the intestines and organs

Front 20

Routes of Administration:

Which type of fluid replacement is best?

Back 20

oral

Front 21

Routes of Administration:

SQ Fluids must be _____________ fluids.

Give 2 examples:

Back 21

isotonic

Normosol, LRS

Front 22

Routes of Administration:

Which type of fluid replacement is safest?

Back 22

oral

Front 23

Advantages of oral fluid administration (2)

Back 23

1. safest

2. easy

(best)

Front 24

Disadvantages of oral fluid administration (3)

Back 24

1. less rapid absorption

2. more risk of aspiration

3. cannot use for vomiting animals

Front 25

Advantages of SQ fluid administration (2)

Back 25

1. easy to administer

2. distributed over time

Front 26

Disdvantages of SQ fluid administration (3)

Back 26

1. slower absorption

2. must use isotonic fluids

3. possible infection

Front 27

Advantages of IV fluid administration (2)

Back 27

1. amount given is available rapidly

2. can use a wide variety of tonicities when it comes to fluid choice

Front 28

Disdvantages of IV fluid administration (3)

Back 28

1. must be sterile

2. possible overload / vessel damage

3. must monitor closely

Front 29

Advantages of IO fluid administration (3)

(intra-osseus)

Back 29

1. rapid absorption

2. can be used when vein is not accessible

3. useful in small animals, pocket pet, birds (exotics)

Front 30

Disdvantages of IO fluid administration (2)

Back 30

1. risk of infection

2. lack of confidence about using this route

Front 31

Advantages of rectal fluid administration (2)

Back 31

1. good absorption

2. rapid absorption

Front 32

Disdvantages of rectal fluid administration (1)

Back 32

not used often

Front 33

_____________ refers to the osmotic pressure of a solution based on the number of particles per kilogram of solution.

Back 33

Tonicity

Front 34

What kind of solution has the same osmotic pressure as blood and extracellular water?

Back 34

isotonic

Front 35

What kind of solution has osmolality lower than that of blood?

What will happen to RBCs?

Back 35

hypotonic

RBCs will swell

Front 36

What kind of solution has osmolality higher than that of blood?

What will happen to RBCs?

Back 36

hypertonic

RBCs will shrink

Front 37

CRYSTALLOIDS:

Name 4 isotonic crystalloid solutions:

Back 37

1. 0.9% sodium chloride (normal saline)

2. lactated ringer's solution

3. Normosol

4. Plasmalyte

Front 38

CRYSTALLOIDS

Name 3 hypotonic crystalloid solutions:

Back 38

1. 5% dextrose in water

2. 0.24% normal saline

3. 0.45% normal saline

Front 39

CRYSTALLOIDS

What do HYPERtonic solutions do?

1 example of a situation they could help?

Back 39

1. draw fluids OUT of tissue

2. help with edema

Front 40

CRYSTALLOIDS

3 examples of Hypertonic Crystalloids:

Back 40

1. 0.9% normal saline + 5% dextrose

2. 10% dextrose in water

3. 3% normal saline

Front 41

Problems with fluid administration:

What is the main potential problem?

Back 41

fluid overload

Front 42

Problems with fluid administration:

Fluid overload is a condition in which the administration of fluid occurs at a greater rate than....

Back 42

the rate at which the body can use or eliminate the fluid

Front 43

Fluid overload is a condition associated with fluids administered via what route?

Back 43

parenteral

(any route but the digestive tract)

Front 44

Signs of fluid overload: (5)

Back 44

1. respiratory changes

2. swallowing

3. restlessness - doesn't want to lie down

4. weight gain

5. fluid deposition in SQ space

Front 45

COLLOIDS:

Cause fluids to move from the _____________ & ___________ spaces into the _____________ space.

Back 45

from the interstitial & intercellular

into the vascular

Front 46

COLLOIDS:

Where do they draw fluids from and where do they put it?

Back 46

draw it out of the cells and tissue and hold it in the vessels

Front 47

COLLOIDS:

Name 3 types of natural colloid solutions:

Back 47

1. plasma

2. whole blood

3. albumin

Front 48

COLLOIDS:

Name 3 types of Synthetic colloid solutions:

Back 48

1. dextrans

2. Hetastarch (hydroxyethyl starch)

3. oxypolygelatin

Front 49

Fluid Additives:

What is the rule to always follow when adding anything to a bag?

Back 49

withdraw & discard in the same amounts

Front 50

Fluid Additives:

Name 5 types

Back 50

1. 50% dextrose

2. potassium

3. calcium

4. sodium bicarbonate (changes pH)

5. vitamins

Front 51

Calculating Fluid Volumes

What 3 things must always be considered when determining fluid volume?

Back 51

1. rehydration

2. maintenance

3. ongoing fluid loss (vomiting, urination, etc.)

Front 52

Maintenance fluid =

Back 52

the volume of fluid needed daily to maintain body function

Front 53

Maintenance fluids can be dosed at what rate for adults / young animals?

Back 53

adults: 50mL / kg / day

young: 100mL / kg / day

Front 54

Calculating maintenance rate:

Adult 14-lb cat

Back 54

14 lb 1kg 50mL = 318 mL

1 2.2 lb 1kg

Front 55

Rehydration:

Is based on the estimated % of ________________.

Back 55

dehydration

Front 56

Rehydration fluid formula:

Back 56

% dehydration x BW in kg = deficit in LITERS

Front 57

Rehydration calculation for:

Adult 14 lb cat @ 3% dehydration

Back 57

14 lbs = 6.36 kg

2.2

.03 x 6.36 = 0.1908 Liters

0.1908 liters x 1000mL = 190.8 = 191mL

Front 58

What is the AAHA recommendation for giving rehydration fluids?

Back 58

Give 80% of the dehydration value in the first 24 hours

Front 59

In the case of this cat (191 mLs rehydration), what should we actually give?

Back 59

153 mLs in first 24 hours

(80% of 191)

Front 60

Calculation for ongoing fluid loss:

This is an estimation based on additional loss of fluid due to ______________ or ____________.

Back 60

vomiting

diarrhea

Front 61

TOTAL FLUID REPLACEMENT CALCULATION:

Back 61

maintenance + 80% of dehydration rate + ongoing loss

Front 62

Our adult 14-lb cat (with 100mLs of loss):

Back 62

318 mL + 153 mL + 100mL = 571 mLs total

Front 63

How / How quickly are fluids given?

Rate of fluid replacement parallels the severity of ____________.

Back 63

dehydration

Front 64

Ideally, fluids are given over a _______________ period.

Back 64

24-hour

Front 65

What is the SHOCK DOSE of fluids?

Back 65

90 mL / lb / day

Front 66

When using a special administration chamber, how much fluid should you allow to flow into the chamber before adding anything to it?

Back 66

10 - 15 mLs

Front 67

Clean the injection site on the administration chamber with ____________.

Back 67

alcohol

Front 68

ER Drugs:

ABC =

Back 68

airway

breathing

circulation

Front 69

ER priorities:

1st

2nd

3rd

4th

Back 69

1. endotrach tube

2. IV catheter

3. pulse ox

4. start bagging patient

Front 70

The goal of ER treatment is to maintain adequate _____________ of vital organs.

Back 70

oxygenation

Front 71

Oxygenation of vital organs is the goal of both the ____________ and the _____________ systems.

Back 71

respiratory

cardiovascular

Front 72

primary goal of the respiratory system:

Back 72

gas exchange

Front 73

primary goal of cardiovascular system:

Back 73

perfusion of organs & tissues

Front 74

ER Drugs:

When making first contact with the owner, obtain the following 5 pieces of info:

Back 74

1. nature of illness / injury

2. condition of animal

3. time of injury / event that occurred

4. pre-existing illnesses / medications

5. signalment