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37 Cards in this Set
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- Back
Intracellular VS Extracellular Fluids
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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) |
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Extracellular Fluid - What are the 3 sections?
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~Vascular (24%) - Fluids inside the vessels
~Interstitial (75%) - Fluids between the Intracellular and Extracellular (Around cells) ~Transcellular (1%) - Fluids found within special compartments |
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Effective Osmoles VS Ineffective Osmoles
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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 |
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Crystalloid Solutions: Balanced vs Unbalanced
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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) |
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Colloid Solutions
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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 |
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Maintenance Fluid Rate
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40 - 60 ml/kg/day
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Sensible VS Insensile Fluid Loss
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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 |
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Ongoing Losses
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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 |
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What are two types of crystaloids that use buffers?
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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 |
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Types of crystaloids
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~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) |
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Types of Colloids
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~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) |
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Shock Fluid Therapy
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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 |
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Volume Dependant Shock Fluid THerapy VS End point resuscitation method
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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. |
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Green Top Tubes
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Contain Lithium Heparin. Spun down to plasma
Used for serum chemistries, ISTAT, etc |
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Blue Top Tube
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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! |
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Purple top tube
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EDTA - Ethylenediamhetetraacitic acid
Used for CBC, blood morphoogy Cannot be used for blood chemistries since it binds to calcium |
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Serum Separator tubes
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No additives - also has silicone or parafin wax to separate serum from the blood.
Spun down to serum Used forr blood chemistries |
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3 Rules of IV Catheters
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Sterile
Secure Tabbed |
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Items needed for IV catheter
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Clippers, alcohol and scrub, IV catheter, Port/hub, Flush, tape
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Over the needle catheter
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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 |
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Thru the needle catheter
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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)
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PICC Line
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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
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Jugular/Central catheter
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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
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Multi-lumen catheter
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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
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Peel-Away catheter
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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
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What are times you may not want to use fluid therapy?
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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 |
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Blue Catheter
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22 g (Used a lot for cats and small dogs)
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Yellow catheter
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24 g For neonates and small exotics
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Red Catheter
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25 g
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Pink catheter
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20 g (Medium)
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Green catheter
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18 g (large)
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Grey catheter
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16 g
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Orange catheter
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14 g
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Butterfly catheter
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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 |
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IV Catheter mainteneance
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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! |
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Pickwickian Syndrome
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When a cat is too fat and has no scruff
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Lateral restraint - what are some procedures that are common for this restraint?
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Used for blood draws, abdominal palpation, limb palpation and abdominocentisis, etc
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