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Pharmacology Exam 3 > Ch.32: Fluid Therapy (Pablo) > Flashcards

Ch.32: Fluid Therapy (Pablo) Flashcards

1
Q

body fluids consist of:

A

water (solvent) and dissolved particles (solutes)

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2
Q

electrolyte

A

compound which dissociates in water to form electrically charged particles (ions). Ex: NaCl and KCl

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3
Q

osmotic pressure

A

pressure which tends to pull water into the compartment containing the solutes

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4
Q

oncotic pressure

A

total osmotic effect of a non-diffusible colloid (proteins)

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5
Q

hydrostatic pressure

A

pressure which tends to push water into the compartment containing less solute

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6
Q

osmolarity

A

number of osmoles per liter of water; depended upon the number of particles in solution

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7
Q

osmolality

A

number of osmoles per kilogram of water. The difference is usually negligible to osmolarity because of the low solute concentrations in the body fluids

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8
Q

effective osmolality

A

osmolality that tends to maintain an effective osmotic pressure because the solute cannot easily diffuse across the membrane

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9
Q

tonicity

A

refers to effective osmolality

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10
Q

colloid sollution**

A

solution that contain large particles that don’t readily leave the vascular space

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11
Q

crystalloid solution**

A

solution that contain electrolytes or solutions of glucose in water. doesn’t stay in IV space for a long time

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12
Q

body weight is what percent water at maturity

A

60%

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13
Q

BW is what percent water in newborns

A

80%

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14
Q

BW is what % water in intracellular space?

A

40%

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15
Q

BW is what % water in extracellular space?

A

20% (15% interstitial and 5% IV)

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16
Q

capillary walls are permeable to:

A

water, solutes; only slightly permeable to proteins

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17
Q

Factors that affect water distr. and movement in body

A

Electrolytes
Hydrostatic and oncotic P
Lymphatic drainage

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18
Q

Hydrostatic P tends to push water/solutes where?

A

into interstitial space

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19
Q

Oncotic P tends to push water/solutes where?

A

IV

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20
Q

plasma water loss –> water movement?

A

from intracellular/interstitium to IV

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21
Q

protein loss –> water movement?

A

IV to interstitial/intracellular space

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22
Q

what does lymphatic drainage do?

A

remove excess fluid in the interstitial space

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23
Q

Abnormal processes affecting water distribution

A
  • vascular injury –> edema
  • changes in electrolyte conc.
  • lymphatic injury
  • altered intravascular osmolality –> inc. plasma osmolality
  • hypoproteinemia –> dec. plasma oncotic P
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24
Q

3 Indications for fluid therapy

A

1) restore normal circulation in patients with hypovolemia or shock
2) correct fluid deficits in dehydrated patients
3) maintain fluid balance in patients with decreased fluid intake/increased fluid loss

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25
Q

name 3 replacement solutions

A

LRS –> most commonly used in SA!
Normosol –> most commonly used in LA!
Normal Saline

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26
Q

chars. of replacement solutions

A

isotonic sodium-based
used for replacement of fluid deficits
similar composition as plasma water
can be given rapidly

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27
Q

“sensible” fluid loss

A

via kidneys/bladder. We are aware of it

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28
Q

“insensible” fluid loss

A

via LI, lungs, skin. We are unaware of it

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29
Q

If ECF and ECF are the same, movement of H2O is at ____

A

homeostasis

30
Q

Is LRS a colloid or crystalloid?

A

crystalloid

31
Q

which fluid stays in interstitial fluid the longest?

A

LRS

32
Q

Which stays IV longer: colloids or crystalloids?

A

colloids

33
Q

2 types of crystalloid solutions. How do they differ in composition?

A

replacement (conc. electrolytes similar to body)

maintenance (lower Na and Cl, higher K than replacement fluids)***

34
Q

Basic components of LRS. alkylizing or acidifying solution?

A 
ALKYLIZING AGENT
Na
K
Ca**
Cl
lactate
35
Q

lactate is precursor for:

A

bicarbonate (converted in liver)

36
Q

Basic components of Plasma-Lyte A. alkylizing or acidifying solution?

A 
ALKYLIZING AGENT
Na
K
Mg**
Cl
Gluconate
Acetate
37
Q

acetate and gluconate converted to:

A

bicarbonate (converted in lungs)

38
Q

Basic components of Normosol. alkylizing or acidifying solution?

A

Same as Plasma-Lyte A

39
Q

can you add bicarbonate to LRS/Normosol?

A

LRS: No (interacts with Ca)
Normosol: Yes

40
Q

disadvantage of giving normosol alone?

A

can develop hypocalcemia. Add Ca glutamate to counteract.

41
Q

Basic components of Ringer’s Solution. alkylizing or acidifying solution?

A 
ACIDIFYING SOLUTION:
Na
K
Ca
Cl**
NO BUFFER BASE
42
Q

use of Ringer’s solution

A

tx for metabolic alkalosis

43
Q

use of 0.9% saline solution. Alkylizing or acidifying solution?

A

Acidifying solution. tx for hyperkalemic animals, metabolic alkalosis
-not ideal replacement solution

44
Q

use of 7.5% saline solution

A

short-lived increase in IV volume in severely hypovolemic animals; used in emergencies only

45
Q

use of 5% dextrose solution

A

free water source**
NO electrolytes, buffer base
Tx for hyperkalemia, hypernatremia, hypoglycemia (as in liver dz, sick neonates, hepatic shunts)

46
Q

contraindication for dextrose solution

A

brain trauma; results in additional brain swelling

47
Q

a true maintenance fluid has low ___

A

Na

48
Q

1/2 strength LRS and 2.5% dextrose can be used as:

A

maintenance fluid if given slowly

49
Q

Choose solution based on:

A

hydration status
history
PE
lab data

50
Q

What is lost in vomiting dogs?

A

H and Cl. Use acidifying solution to help

51
Q

What is lost in diarrhea dogs?

A

Na and bicarb. Use alkylizing solution to help restore water and electrolytes

52
Q

T/F: horses lose less fluid per kg of body weight lost than small animals?

A

T

53
Q

What should be included in a lab workup when assessing fluid status?

A 
Plasma protein**
PCV**
blood gas
electrolytes
osmolality
urinalysis
54
Q

Dehydration –> PCV, plasma protein?**

A

both increase

55
Q

Dehydration + anemia –> PCV, plasma protein?**

A

PCV unchanged, plasma protein increases

56
Q

dehydration + hypoproteinemia –> PCV, plasma protein?**

A

PCV increases, plasma protein unchanged or decreases

57
Q

When developing a fluid therapy plan, must calculate:

A
  • existing deficit
  • maintenance requirement
  • contemporary loss
58
Q

Deficit in L =

A

% Dehydration x bw (kg)

59
Q

total maintenance requirement = **

A 
sensible loss (urine) + insensible losses
**usually 40-60ml/kg/day**
60
Q

big dogs have higher/lower fluid requirements than small dogs

A

lower!

61
Q

contemporary loss

A

loss of fluids via v/d, internal bleeding, etc.

-hard to keep track of

62
Q

Total fluid volume to administer over 24 hrs =

A

deficit + maintenance + ongoing loss

63
Q

How quickly should you restore blood volume in case of severe dehydration?

A

within 1 hr

64
Q

Ways to monitor fluid therapy

A

PE**
lab work**
urine output
central venous pressure

65
Q

specific gravity is higher/lower when animal is dehydrated?

A

higher

66
Q

signs of improvement

A 
more elastic skin turgor
moister MM
animal looks brighter
inc. BW
PCV, TP, specific gravity dec.
HR dec.
eyes less sunken in
67
Q

Which fluid therapy should you NOT give SC?

A

dextrose

68
Q

T/F: fluids are only a supportive therapy

A

T

69
Q

<5% of dehydration CS

A

not detectable

70
Q

9-12% of dehydration CS

A 
tented skin stands in place
prolonged CRT
sunken eyes
dry MM
possible signs of shock
71
Q

When normal saline given IV, where does most of it go?

A

most stays in ECF

72
Q

contraindication of using normal saline

A

animal with CHF

Pharmacology Exam 3 (11 decks)

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