Fluid Therapy And Week 2 Stuff

Front 1

Intracellular VS Extracellular Fluids

Back 1

Intracellular (ICF) - Fluid within the cells

Extracellular (ECF) - Fluid found outside the cells

Intracellular has 2/3 of the total body fluids and Extracellular fluids contain the rest (1/3)

Front 2

Extracellular Fluid - What are the 3 sections?

Back 2

~Vascular (24%) - Fluids inside the vessels

~Interstitial (75%) - Fluids between the Intracellular and Extracellular (Around cells)

~Transcellular (1%) - Fluids found within special compartments

Front 3

Effective Osmoles VS Ineffective Osmoles

Back 3

Effective - Moleclules that cannot cross over the membrane. Will cause osmosis to occur

Ineffective osmoles - Molecules that can cross over the membrane (Will NOT cause osmosis to occur

Tonicity is determined by the amount of effective/ineffective osmoles in the solution

Front 4

Crystalloid Solutions: Balanced vs Unbalanced

Back 4

Contains variety of solutes and non-solutes that can enter into every fluid compartment

Two types - ReplAcement and maintenance

Balanced - Contain buffers and have electrolyte compositions that resemble plasma (LRS

Unbalanced - Do not contain buffers and do not resemble plasma (0.9 NaCl)

Front 5

Colloid Solutions

Back 5

High molecular weigght substances that cannot cross the vascular membrane. Can be snthetic or natural

Large sized proteins/molecules will remain in the vascular space until they are broken down

Used to help improve/increase vascular volume and correct hydration deficits

Front 6

Maintenance Fluid Rate

Back 6

40 - 60 ml/kg/day

Front 7

Sensible VS Insensile Fluid Loss

Back 7

Sensible - Fluid losses account for 2/3 of daily losses. From urination - easy to measure

Unsensible - Account for the remaining 1/3 of daily losses. Include fluid loss from feces and panting. This cannot be measured, is more of an estimate

Front 8

Ongoing Losses

Back 8

Any lossres outside of the normal losses.

Include vomiting/diarrhea, excessive panting, fever, trauma

These losses should be estimated to determine what volume is needed to correct the fluid deficit

Front 9

What are two types of crystaloids that use buffers?

Back 9

Normasol-R/Plasmalyte A - May cause transient hypotension. In cats may see transient nausia/vomiting with high bolus amounts

Lactate in LRS - Use caution in patients with liver disease. Do not use w/ blood products

Front 10

Types of crystaloids

Back 10

~LRS (potassium, sodium, calcium, and chloride)

~Plasmalyte - A/Normasol-R (Sodium, potassium, chloride)

~Sodium Chloride/PSS/0.9 NaCl (contains sodium and potassium only, no bffers)

~ 5% Dextrose (No electrolytes or buffers - Used mainly to give free water)

0.45 NaCl in 2.5 Dextrose (half strength saline w/ half strength dextrose - Used for potential fluid overload, no buffers)

Front 11

Types of Colloids

Back 11

~Hetastarch (not able to be broken down by body easily, will remain in vascular space. Will cause fluid to rush into the vascular space)

~Pentastarch (Not available in US)

~Dextrans (Colloid solution, not commonly used. May increase clotting times)

~Natural Colloids - Blood products (Fresh whole blood, plasma, etc)

Front 12

Shock Fluid Therapy

Back 12

Crystalloids are common first choice for SHOCK

Hetastarch is used during shock in addition to the crystaloids to help bring fluids back into the vascular space

Front 13

Volume Dependant Shock Fluid THerapy VS End point resuscitation method

Back 13

Giving the patient large volumes of fluids at a fast rate to quickly replace losses

~90 ml/kg dog and 55 ml/kg in cats

"End Point" - Allows clinician to set vital sign parameters as "goals" to reach and fluid therapy is continued or stopped once those parameters are met.

Front 14

Green Top Tubes

Back 14

Contain Lithium Heparin. Spun down to plasma

Used for serum chemistries, ISTAT, etc

Front 15

Blue Top Tube

Back 15

Sodium Citrate

Used for clottingg times, CANNOT be used for chemistries.

a 9 to 1 ratio (9 parts blood 1 part sodium citrate)

needs to bbe atleast 2/3 or 3/4 full!

Front 16

Purple top tube

Back 16

EDTA - Ethylenediamhetetraacitic acid

Used for CBC, blood morphoogy

Cannot be used for blood chemistries since it binds to calcium

Front 17

Serum Separator tubes

Back 17

No additives - also has silicone or parafin wax to separate serum from the blood.

Spun down to serum

Used forr blood chemistries

Front 18

3 Rules of IV Catheters

Back 18

Sterile
Secure
Tabbed

Front 19

Items needed for IV catheter

Back 19

Clippers, alcohol and scrub, IV catheter, Port/hub, Flush, tape

Front 20

Over the needle catheter

Back 20

Catheter is on the outside of the needle. When placed, needle is removed and catheter is taped into place.

Most common type of catheter used. Used in peripheral veins to give fluid therapy/drug admin. Needle sticks out about 1 mm

Front 21

Thru the needle catheter

Back 21

needle wrapped in plasticc(sterile and protected) tjat feeds up through the needle (needle is bigger than catheter and feeds up through until it latches in and a cover case is snapped on to protect patien from needle. Can keep in for 7 - 10 days (sometimes 14 depending on the brand)

Front 22

PICC Line

Back 22

Peripherally inserted central catheter. A long catheter placed in a peripheral limb that is very long and is inserted all the way up to the heart

Front 23

Jugular/Central catheter

Back 23

Catheter placed in the jugular, used when drugs that are irritatinbg to periferal vessels (dextrose) are needed, monitoring CVP, repeated blood draws and large volume of fluid infusions. Must be taped so that the neck movement cannot kink the line and also must be bandaged and e-collared

Front 24

Multi-lumen catheter

Back 24

Has 2 to 4 seperate lumens in one catheter that allow simutaneous infusions at one catheter site, w/o having any of the fluids mix. Provides the same function as 2 or 3 catheters, usually completed percutaneously w/ a guidewire and can be pricey

Front 25

Peel-Away catheter

Back 25

Needle inside w/ catheter that has 2 bends on the side. When you place it, you pull your needle out, put a catheter through the bends, then peel the bends away

Front 26

What are times you may not want to use fluid therapy?

Back 26

Congestive heart failure and Pulmonary edema

~Can have certain types, but must be cautious on what/how you give fluids. Also be cautious on flushing catheter

Front 27

Blue Catheter

Back 27

22 g (Used a lot for cats and small dogs)

Front 28

Yellow catheter

Back 28

24 g For neonates and small exotics

Front 29

Red Catheter

Back 29

25 g

Front 30

Pink catheter

Back 30

20 g (Medium)

Front 31

Green catheter

Back 31

18 g (large)

Front 32

Grey catheter

Back 32

16 g

Front 33

Orange catheter

Back 33

14 g

Front 34

Butterfly catheter

Back 34

Short term use for bolus injecions or blood draws

Cephalic (most common)
Lateral saphenous (euthanasia)
Femoral (cats)

Disadvaqntages: extra tubing, easier to damage the vessel, requires constant supervision, easy to dislodge

Front 35

IV Catheter mainteneance

Back 35

Tape and bandages must be kept clean and dry

Watch for: redness, irritation, swelling above, at or below the site.

REPLACE EVERY 72 HOURS MINIMUM!

Front 36

Pickwickian Syndrome

Back 36

When a cat is too fat and has no scruff

Front 37

Lateral restraint - what are some procedures that are common for this restraint?

Back 37

Used for blood draws, abdominal palpation, limb palpation and abdominocentisis, etc