5. Fluid Therapy

Question 1

What is fluid therapy?

Answer 1

Giving fluids to a patient to correct dehydration, acid-base imbalances, electrolyte disturbances, shock, hemorrhage, hypotension, to maintain BP during general anaesthetic

Question 2

What are the routes of delivery?

Answer 2

Per Os (mouth)
SQ fluids
IV
Intraosseous

Question 3

Describe the route per os

Answer 3

by mouth, #1 preferred route, takes time to absorb + redistribute, works for mild dehydration (5%)
conscious patient
patient cannot be V/D, unconscious, seizuring, GI obstruction, colid or acute abdomen

Question 4

Describe the route intravenous?

Answer 4

sterile fluids delivered by iv line or catheter
fastest route
LG volumes over long period, works in all conditions
only choice if marked to severely dehydrated
perferried if hypotensive

Question 5

What info is required for IV fluids?

Answer 5

time of placement, loc and size
fluid type, fluid rate
start/stop
total volume infused
record of periodic checks

Question 6

Describe the route SQ

Answer 6

under the skin
best in cats
only limited volume this way, slowly absorbed
too lg will cause tearing of CT between skin/underlying tissue (avulsion injury in dogs)
best to use warmed fluids
Standard SQ fluid volume in cats 100ml/cat/day

Question 7

Describe the route IO

Answer 7

intraosseous, into the medulary canal of a large bone
used in neonates and exotics for lg volumes

Question 8

What is the 3 goals of fluid therapy?

Answer 8

Correct the volume of blood water
Restore normal BP
Correct any electrolyte imblances

Question 9

What is a crystalloid?

Answer 9

Most common
Sm ions move btw body compartments
3 categories (normal saline, balanced solutions, hypertonic saline)
Hypertonic only in emergency hypotension

Question 10

What is a colloid?

Answer 10

Used in low bp situations
Lg molecules stay in blood vessels
Inc with oncotic pressure to draw water into blood vessels
Exta hetastarch, dextran

Question 11

What are blood products

Answer 11

Whole blood, plasma, blood cells, platelets
Used during bleeding, blood loss, clotting disorders

Question 12

What is maintenance volume?

Answer 12

How much the animal needs daily to aquire in order to stay alive

Question 13

What is replacement volume, how do we calculate it?

Answer 13

Amount of fluid required to correct patients dehydration

Replacement volume (L) = Deficit volume (L)

( %dehydration) x (weight in kg)

Question 14

What are onglong losses?

Answer 14

Applies to a patient losing fluid by V/D, and/or polyuria

Question 15

What are some issues that arise with fluid therapy?

Answer 15

Failure to correct dehydration
Overhydration
IV cath slips and fluids go SQ
Phlebitis or thrombosis
Cath related infections
Cath embolism
Crating electrolye imbalances

Question 16

Describe normal saline

Answer 16

Restoring hydration, flushing tissue cavities, high lvls of Cl, useful if low na or cl
Salf water

Question 17

Describe a balanced solution

Answer 17

Normosol-M or 0.45% salinefor maintenance fluid
Normosol-R, LRS, 0.9% saline for replacement
Solutions contain diff conc of Na, K, Cl, bicarbonate, Ca and dextrose
Selection based of best for restoring normal electrolyte balance in patient

Question 18

What is a hypertonic saline solution?

Answer 18

Emergency use for pulling water out of blood tissues or into the blood vessels
Conc saline (2%, 3%, 5%, 7%, 23%)
Inc osmotic pressure in blood vessels -pulls water in - enters vessels - stays in vessels briefly