Fluid Therapy *final (Packet 4 Of 4)

Front 1

How much of the body is composed of fluid?

Back 1

60%
-2/3 of that is found within the cells and is known as Intracellular Fluid.
-1/3 of that lies outside the cells and is called Extracellular Fluid.

Front 2

What are the 3 types of Extracellular Fluid and where are they found?

Back 2

1.INTERSTITIAL FLUID-surrounds the cell and is outside of the blood vessels.
2.TRANSCELLULAR FLUID-includes *cerebral spinal fluid, *synovial fluid, *lymph fluid, *intraocular fluid.
3.INTRAVASCULAR FLUID-fluid containted within the blood vessels as Plasma.

Front 3

Define Tonicity:

Back 3

Tonicity: the ability of a solution to initiate water movement. Depends on the solutes present and their ablity to pass through a membrane. There are 3 types:
1.Isotonic
2.Hypotonic
3.Hypertonic

Front 4

Tonicity: 3 types

Back 4

1.ISOTONIC-fluid where normal cells will not shrink or swell. (Ex: 0.9% NaCI and LRS)
2.HYPOTONIC-fluid that causes cells to swell (water moves into the cell) (Ex: 2.5% Dextrose solution)
3.HYPERTONIC-fluid that causes cells to shrink (water moves out of the cell and into the solution) (Ex:7% NaCI)

Front 5

What are Electrolytes?

Back 5

Electrolytes: compounds that are formed by ions and remain as a solution. They are responsible for the alkalinity or acidity of a solution.

Front 6

What are the 2 Electrolytes Routinely measured in Fluid Therapy?

Back 6

1. SODIUM
2. POTASSIUM

Front 7

What are the Normal Values for SODIUM and where is it most commonly found?

Back 7

SODIUM normal value:
140 meq/dL
-Most abundant EXTRACELLULAR ion present!
-attracts water
-responsible for determining extracellular fluid volume

Front 8

Name 4 ways other than dehydration that animals can lose sodium from their bodies:

Back 8

1.Urinary loss
2.G.I. loss
3.3rd Space loss
4.Cutaneous loss

Front 9

What are the Normal Values for POTASSIUM and where is it most commonly found?

Back 9

POTASSIUM normal value:
3.5 to 5.0 meq/dL
-Primary INTRACELLULAR ion!
-responsible for generating electrical impulses in muscles & nerves.
-changes in plasma alter nerve and cardiac function.

Front 10

What is the Maximum Rate of POTASSIUM supplementation in fluids?

Back 10

Max Potassium Supplementation in fluids:
0.5 meq/kg/hr
*device called Sliding Scale of Scott determines values for potassium supplementation.
**NEVER give the undiluted form of potassium directly into an animals circulation, will cause CARDIAC ARREST! NEVER IV....Must be put into bag!

Front 11

What is Acid-Base Balance?

Back 11

Acid-Base Balance: refers to the regulation of hydrogen ion concentration in body fluid (pH)

**Normal pH of Arterial blood is 7.4

Front 12

What is ACIDOSIS?

Back 12

-Acidosis: LOW BLOOD pH that corresponds to HIGH levels of Hydrogen ion.

Front 13

What is ALKALOSIS?

Back 13

-Alkalosis: HIGH BLOOD pH that corresponds to LOW levels of Hydogen ion.

Front 14

How do you maintain body fluid volume in an animal?
(maintenance fluid requirements)

Back 14

An animals daily intake of fluid must equal the sum of Sensible and Insensible Losses.

Front 15

What are SENSIBLE WATER Losses, and how much is lost?

Back 15

Sensible Water Losses:
-Lost through URINE- 10mL/lb/day
-Lost through FECES-
3-5mL/lb/day

Front 16

What are INSENSIBLE WATER Losses, and how much is lost?

Back 16

Insensible Water Losses:
-Lost through RESPIRATIONS
-Lost through TRANSCUTANEOUS losses
Total from Both= 7.5mL/lb/day

Front 17

What is the amount needed for MAINTENANCE of Normal Body Fluid per day?

Back 17

Maintenance Fluids:

30 mL/lb/day

Front 18

What are the Stages of DEHYDRATION?
What happens at each Stage?

Back 18

Degree of Dehydration:
-less than 5%: not detectable
-6-7%: mild loss of skin elasticity
-8-9%: obvious delay in tented skin,slight prolonged CRT,dry/tacky mm's,eyes little sunk
10-12%:(Cats are at 10% if any dehydration is detected!)skin remains tented,very prolonged CRT, sunken eyes in orbits, dry mm's, possible signs of shock
-13-15%:obvious signs of shock, Death Imminent :(

Front 19

What is the amount needed for REPLACEMENT fluids?

Back 19

*Remember, 1L=1kg, so for every kg of body weight the animal has lost it has also lost 1L of fluid.
Replacement Fluids:

% of dehydration X body weight(kg) X 1000

(% x kg x 1000)

*daily fluid requirements: replacement volume + maintenance volume

Front 20

Define Dehydration:

Back 20

Dehydration: reduced total body water w/ preservation of vascular volume.
(replace slowly as not to over expand the vascular space)

Front 21

Define Hypovolemia and Shock:

Back 21

Hypovolemia/Shock: reduced intravascular volume (which can impair cardiac output).
(must rapidly replace fluids in order to re-expand the intravascular volume.

Front 22

What are the Signs of Hypovolemia and Shock?

Back 22

Signs of Hypovolemia/Shock:
-weakness
-CRT longer than 3 seconds
-pale mm's
-low body temp.

Front 23

What are the Hypovolemia/Shock dose of fluids?

Back 23

Hypovolemia/Shock fluid dose:
*these considerations should always be considered in any Trauma Patient!
-Require fluid replacement at:

60 mL/kg/hr (emergency fluid)

Front 24

What is a COLLOID?

Back 24

Colloid: fluid product that contains large molecular weight molecules that remain in the vascular space until they are degraded by the body.
-they are used to increase oncotic pressure
-Can be used in Shock Situations!

Front 25

What is the Most Commonly used COLLOID?

Back 25

HETASTARCH most common used product

Front 26

What rate is COLLOID administered at?

Back 26

-The Flow Rate is up to 20mL/kg/day IV over whole day, or can be given over 30 min. for DOGS.
CATS flow rate: 15mL/kg slowly for 20-30 minutes.

Front 27

What is the Electronic Infusion Pump Rate Method?

Back 27

Electronic Infusion Pump Method: involves the use of an electronic infusion pump, a bag of fluids, and an IV drip set.
(calculated by machine @ ml/hr)

Front 28

Common Solutions
Lactated Ringer Solution LRS
Characteristics:

Back 28

LRS: this is used for most maintenance situations
-lactate helps prevent and treat metabolic acidosis.
-provides normal level of potassium to prevent hypokalemia from vomiting, lack of daily intake, etc

Front 29

Common Solutions
Normal Saline (0.9% NaCI)
Characteristics:

Back 29

Normal Saline (o.9% NaCI):
-an isotonic fluid
-most commonly used in animals who need a normal osmotic solution w/o potassium, like hyperkalemic

Front 30

Common Solutions
LRS with 5% Dextrose or 0.45% NaCI with 5% Dextrose
Characteristics:

Back 30

LRS w/ 5% Dextrose or 0.45% NaCI w/ 5% Dextrose:
-used in animals that need a sourse of Dextrose to maintain blood sugar levels, like hypoglycemic

Front 31

Common Solutions
Fluid Supplements-Dextrose 50%
Characteristics:

Back 31

Fluid Supplements-Dextrose 50%:
-used to add Dextrose to any fluid (up to 5%)
-Potassium Chloride: very common additive (use Sliding Scale of Scott to determine amount to add)

Front 32

What are Constant Rate of Infusions?

Back 32

Constant Rate of Infusions: drugs that are administered as an infusion (usually placed in a bag of fluids) and are given continuously over a set period of time. (pain meds, electrolytes, anti-sezure meds, and antibiotics are commonly given as constant infusion)

Front 33

In order to determine how much of a drug needs to be added to a bag of fluids, what 5 key pieces of information do we need to know?

Back 33

5 key pieces of info to know how much drug to add to a bag of fluid:
1.rate at which fluids are being administered
2.drug name and dose
3.drug concentration
4.patient weight
5.size of fluid bag being used