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59 Cards in this Set
- Front
- Back
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What are the 8 most common usages of fluids?
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1) Correct dehydration
2) Correct electrolyte and acid- base imbalances -replacement, diuresis, increase uptake by live or other tissues 3) Increase circulatory volume, CO, and peripheral perfusion 4) Increase urination 5) Increase GI, pulmonary and other secretions 6) Vehicle for other treatments 7) Wash out or dilute other substances -Flush out inflammatory debri, nitrogenous wastes 8) Maintenance |
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What are 2 ways that animals lose aqueous and electrolyte components throughout the day?
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1) Excretion of bodily fluids
-ocular, nasal, and oral discharges, urine, feces, sweat, milk 2) Evaporative losses through body surfaces and respiratory tract |
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Water and electrolyte loss are normally replaced through ______ and ______.
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Ingestion or imbibition of water and feed
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What are 3 general abnormal conditions that can lead to dehydration and/or electrolyte derangements?
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1) Increased loss
-diarrhea, polyuria, choke 2) New routes of loss -draining wounds 3) Intake can diminish |
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Non-excretable body fluids exist in what 2 discrete compartments?
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ICF & ECF
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What are the 2 compartments of ECF?
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Intravascular blood (IV-ECF)
Extravascular/interstitial (EV-ECF) |
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What is the name of the third pool of fluid that composes body fluids such as glomerular filtrate and intestinal luminal fluid that are still being modified by the body prior to ultimate excretion of the remainder?
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Transcellular water
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The ECF is composed of high concentrations of ______, ______ and ______.
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Sodium, chloride and albumin
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The ICF is composed of high concentrations of ______ and _______.
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Potassium and phosphorus
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True or false. Movement of fluid and electrolytes between the IV-ECF and EV-ECF is restricted.
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False, moves relatively freely
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Albumin and some other protein molecules move with greater difficulty and tend to remain in the _______.
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IV-ECF
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Protein molecules create a ______ force that tends to draw fluid into the vascular space from the interstitium.
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Osmotic force (plasma oncotic pressure)
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As the intravascular fluid creates pressure against the blood vessel walls, _______ pressure causes fluid to exude into the interstitium.
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Hydrostatic
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What 2 things determine the ratio of fluid within the IV-ECF and EV-ICF?
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Balance of hydrostatic pressure versus osmotic pressure
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What can cause depletion of the intravascular pool of fluid without actually causing dehydration? What are the sequelae?
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Pathologic conditions can cause shifts of fluid from the IV-ECF into the interstitial and transcellular pools
-causes negative impact on cardiovascular function and tissue perfusion |
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With severe enough changes in the ECF, electrolyte change will also occur in the ______.
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ICF
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Why are electrolyte changes in extravascular ECF more difficult to monitor than changes in the V-ECF?
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Most clinicopathologic measurements are performed on blood- IV-ECF
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**Practically _______ has been a good estimator of ECF in adult large animals and _______ in neonates.
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Adults: 0.3 x BW
Neonates: 0.5 x BW |
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Because of their lack of gut fermentative properties, the ***ECF in small animals is estimated to be _______ in adults and ______ in neonates.
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Adults: 0.4 x BW
Neonates: 0.6 x BW |
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What is the estimate of IV-ECF in small and large animals?
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8% of BW is used in humans-which is similar to small animals and neonate large animals. 6-7% is probably more accurate for adult large animals
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1 kg= ____ L
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1 L
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When we determine a rationale for administration of fluids we create a fluid therapy plan consisting of what 4 things?
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1) Type of fluid
2) Rate of administration 3) Route of administration 4) Schedule and type of monitoring |
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**Most therapy plans can be divided into _______ phase and a ______ phase.
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Replacement- long and complicated, used to correct deficits present on initial evaluation
Maintenance - quick & simple, used to keep animal w/in certain homeostatic parameters for a longer period of time |
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What are 4 types of fluids?
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1) Crystalloids (salts)
2) Colloids 3) Blood or blood replacers 4) Energy supplement |
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When are crystalloids use for fluid administration?
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Replace water
Correct electrolyte and acid base disturbances |
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What are 3 examples of colloids used for fluid therapy?
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1) Plasma (natural)
2) protein 3) synthetic colloids -unnatural, mimics proteins, big enough to stay in IV compartment |
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What are 4 situations in which you would want to use colloids for fluid therapy?
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1) Replace lost protein
2) Supply deficient immunoglobulin 3) Supply specific immunoglobulin 4) Increase IV-ECF oncotic pressure |
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Blood or blood replacers have the same benefits as _______.
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Colloids
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The benefit of using blood or blood replacers is it increases ________.
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Oxygen carrying capacity of blood
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What type of fluids can be used for replacement?
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All 4 of them
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Most available crystalloids are formulated for the purpose of replacement and contain what concentrations of electrolytes?
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Concentrations similar to that found in normal plasma or at least similar osmolality
-allows you to give lots of fluids w/o hemolysis |
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During the replacement phase of fluid therapy our goal is to correct hydration deficits, usually over about _______ hours.
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4 hours
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What is the general rule for the shock dose of fluids?
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A BLOOD VOLUME may be given over 20 minutes
-Remember: patients in shock will not always be dehydrated |
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How many fluids would you want to give a 100 kg animal that is in shock?
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8 L, blood volume= 8% of BW
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Dehydration is usually estimated based on the physical exam and can be conveniently judged according to the __________ lost.
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% BW lost
-but pre-hydration weights are not always available |
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What are some common clinical data measurements used to estimate the degree of dehydration?
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BUN and creatinine (poor renal function may be due to underperfusion)
PCV and total protein |
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Dehydration < _____% is usually subclinical, except in neonates and physical exam will reveal no abnormalities.
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6%
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What will you see in an animal that has lost 6% of body weight in fluids?
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Skin tent: 1-3 sec
Mucous membranes: moist to slightly tacky Eyes: normal Other: Decreased urine |
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What will you see in an animal that has lost 8% of body weight in fluids?
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Skin tent: 3-5 sec
Mucous membranes: tacky Eyes: normal Other: weaker pulse |
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What will you see in an animal that has lost 10% of its BW in fluids?
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Skin tent: 5+ sec
Mucous membranes: dry Eyes: Sucken Other: poor jugular fill |
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What will you see in an animal that has lost 12% of its BW in fluids?
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Skin tent: forever
Mucous membranes: Dry, pale and cold Eyes: Sunken Other: pulse? |
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What is the only animal that usually survives long enough to develop severe dehydration?
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Cattle- they're soldiers compared to other animals
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How much fluids would you want to give a 30 kg collie with a skin tent of 4s, azotemia and starting to get shocky?
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Estimate has lost 8% of BW so give 0.08 X 30 kg= 1.8 L/day
-Usually given over 2-4 hours |
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The amount of fluid administered for maintenance should equate to what amount?
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Amount used or lost over the same period of time
-Remember: an animal loses and replaces fluid irregularly during the day |
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What are some abnormal conditions that can increase the amount of fluids needed for maintenance therapy?
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May be increased 2 to 4 fold by activity, hyperthermia, milk production, vomiting, diarrhea, polyuria and a variety of other conditions
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What will you see in an animal that has lost 12% of its BW in fluids?
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Skin tent: forever
Mucous membranes: Dry, pale and cold Eyes: Sunken Other: pulse? |
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What are the 5 routes of administration for fluid therapy?
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1) Oral
2) SQ 3) Intravenous 4) Intraosseous 5) Intraperitoneal |
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What is the only animal that usually survives long enough to develop severe dehydration?
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Cattle- they're soldiers compared to other animals
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Oral fluid therapy is the cheapest and requires the least medical equipment, so why can't we always use it?
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Requires functional, moving gut
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What are the disadvantages of SQ fluid administration? Advantages?
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Disadvantages: requires sterile procedures and some medical equipment and limited by amount of subcutis, aesthetic considerations; poorly absorbed in very dehydrated patients and cannot give hypertonic fluids this way
Advantages: bypasses gut and well absorbed in most patients |
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What are the advantages and disadvantages of IV fluid administration?
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Advantages: most rapid correction
Disadvantages: requires sterile procedure, medical equipment and training |
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The amount of fluid administered for maintenance should equate to what amount?
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Amount used or lost over the same period of time
-Remember: an animal loses and replaces fluid irregularly during the day |
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What are some abnormal conditions that can increase the amount of fluids needed for maintenance therapy?
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May be increased 2 to 4 fold by activity, hyperthermia, milk production, vomiting, diarrhea, polyuria and a variety of other conditions
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When do you want to use intraosseous fluid administration?
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Neonates and other small animals w/ poor venous access
-similar advantages and disadvantages as IV |
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What are the advantages and disadvantages of IV fluid administration?
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Advantages: most rapid correction
Disadvantages: requires sterile procedure, medical equipment and training |
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When do you want to use intraosseous fluid administration?
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Neonates and other small animals w/ poor venous access
-similar advantages and disadvantages as IV |
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Intraperitoneal fluid administration is similar to SQ administration, but how does it differ?
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Absorption is less restricted in severely dehydrated patients and need for sterility is greater
-rarely used |
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What are 6 ways that we can monitor fluids to avoid overhydration and overtreatment?
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1) Body weight
2) Physical determinants: heart rate, mucous membranes, skin turgor, eye luster 3) Central venous pressure 4) PCV/ TP; measure of azotemia 5) Urine volume 6) Evidence of pulmonary or peripheral edema |
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In general, when can fluids be discontinued?
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When animal is getting enough fluid from other sources to maintain itself
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