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sem 5: sam 1 > Approach to a Dyspneic Patient + Fluid Resuscitation > Flashcards

Approach to a Dyspneic Patient + Fluid Resuscitation Flashcards

1
Q

What are ways O2 can be supplemented?

A
  1. Flow by
  2. Face mask
  3. O2 cage
  4. Nasal O2 canula (high O2 flow)
  5. Intubation + manual or mechanical ventilation
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2
Q

__________ is a form of noninvasive ventilation with high O2 flow rates of 1-2 L/kg/min

A

High flow nasal cannula

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3
Q

What POC diagnostic test can help differentiate between CHF vs primary respiratory tract disease?

A
  • Brain natriuretic peptide (proBNP)
  • POC ultrasound to check for B lines or atrial enlargement (Indicates heart issue)
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4
Q

What is the approximate blood volume in dogs and cats (mL/kg)

A

Dogs: 80-90 mL/kg
Cats: 60 mL/kg

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5
Q

____% dehydration results in significant hypovolemia and can be fatal

A

10-12%

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6
Q

How can interstitial dehydration be assessed?

A
  • MM moisture
  • Skin tent response
  • Eye position and corneal moisture
  • Hemoconcentration (PCV)
  • USG
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7
Q

How can intravascular dehydration be assessed?

A
  • MM color, CRT, HR, pulse quality
  • Lactate
  • Blood pressure
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8
Q

Which of the following cannot be assessed on physical exam?

A. Interstitial dehydration
B. Intravascular dehydration
C. Intracellular volume

A

C. Intracellular volume

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9
Q

What are signs of overhydration and risks of fluid overload?

A
  1. Chemosis
  2. Serous nasal d/c
  3. Interstitial edema
  4. Ascites
  5. Pleural effusion
  6. Pulmonary edema
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10
Q

Which of the following is true about giving a fluid bolus?

A. Used to treat hypovolemia
B. Used to treat dehydration

A

A. Used to treat hypovolemia

Fluid bolus not indicated for tx of dehydration

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11
Q

What is the approximate maintenance rate in dogs vs cats vs neonates (mL/kg/d)?

A

Dogs: 60-66 mL/kg/d
Cats: 40-50 mL/kg/d
Neonates: 80-200 mL/kg/d

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12
Q

What is a “shock dose” of IV fluids?

A
  • Shock dose is based on the approx blood volume of the animal

(Dogs: 80-90 mL/kg, Cats: 60 mL/kg)

1/4-1/3 of the shock dose is given

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13
Q

If a patient initially had a lactate of 6, and now it is 2. What does this mean?

A

Perfusion is improving and anaerobic glycolysis is decreasing

Known as lactate clearance

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14
Q

List the unbuffered fluid solutions

A
  1. 0.9% NaCl
  2. 0.45% NaCl
  3. DSW (5% dextrose in water)
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15
Q

Which of the following is not a measure to assess intravascular dehydration?

A. CRT
B. Pulse quality
C. Skin tent response
D. Lactate levels

A

C. Skin tent response

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16
Q

What does “buffered” fluids vs unbuffered fluids mean?

A

Buffered fluids have lactate, acetate or gluconate that act as buffers

D5W and NaCL solutions are unbuffered

17
Q

What is the maintenance rate for the following
Dogs:
Cats:
Pediatric/Neonates:

A

Dogs: 60-66 mL/kg/d
Cats: 40-50 mL/kg/d
Pediatric/Neonates: 80-120 mL/kg/d

18
Q

Convert 25kg to liters

A

25kg=25L

19
Q

What is the shock dose for a 6kg adult dog?

A
  • Based on blood vol (80-90 mL/kg)
  • Give 1/4-1/3 shock dose
  • 1/4 shock dose of 80 = 20mL/kg
  • 20 mL/kg x 6kg = 120 mL shock dose
20
Q

What is the shock dose for a 3 kg cat?

A
  • Based on blood vol (60 mL/kg)
  • Give 1/4-1/3 shock dose
  • 1/4 shock dose of 60 = 15mL/kg
  • 15 mL/kg x 3kg = 45 mL shock dose
20
Q

What fluid would you give in a hyperkalemic, Hypercalcemic patient?

A

0.9% NaCl

21
Q

What are the common buffers found in IV fluids?

A
  • Lactate
  • Acetate
  • Gluconate
22
Q

Hypovolemia is a loss of fluid from the ___________ space

A

intravascular

23
Q

Dehydration is a loss of fluid from the ___________ space

A

Interstitial and intracellular

24
Q

What does the presence of B lines indicate?

A

Interstitial lung fluid (edema, hemorrhage)

25
Q

What is the fluid of choice for an Addisonian patient?

A

(Low Na, High K)

  • Give 0.9% NaCl
26
Q

True or False: Metabolic acidosis should be treated with crystalloid fluids that contain a buffer

A

True

(Ex: DKA, Lactic acidosis, uremia, ethylene glycol toxicity = give LRS, Plasmalyte R or Norm R)

27
Q

Dextrose containing fluids are limited to patients with __________

A
  • Severe hypernatremia
  • Patients that can’t tolerate high levels of sodium (Heart failure)
  • Hyperaldosteronism
28
Q

What fluid would you give to a blocked cat with hyperkalemia?

A

0.9% NaCl

sem 5: sam 1 (26 decks)

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