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ZUKU NAVLE PREP > Flash Notes Miscellaneous - Fluid Therapy > Flashcards

Flash Notes Miscellaneous - Fluid Therapy Flashcards

1
Q

what is osmolarity? what is osmolality?

A

osmolarity: number of particles/liter of solution ~ total concentration of a solution or fluid environment measured in milliosmoles/liter, osmolality: same but measured in milliosmoles/kg

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2
Q

what is tonicity?

A

effect of a solution/fluid environment has on cell colume, so fluid moves in response to the concentration gradient created by the surrounding environment limited by the permeability of the cell membrane - effective osmolarity of the surrounding fluid/environment on cell volume

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3
Q

what is isotonic? hypotonic? hypertonic?

A

isotonic: no change, hypotonic: increase in volume, so cells swell, & hypertonic: volume decreases, so cell shrinks

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4
Q

what is hypovolemia?

A

ineffective circulating blood volume, absolute hypovolemia: actual loss of fluid out of the vascular space, relative hypovolemia: usually caused by vasodilation such that circulating volume is inadequate (seen with severe inflammatory conditions like anaphylaxis/sepsis)

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5
Q

what are replacement fluids?

A

fluids used to replace deficits (similar to plasma) given as bolus or continuous infusion

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6
Q

what are maintenance fluids?

A

fluids used for daily requirements, so lower levels of sodium/chloride than plasma but higher levels of calcium, potassium, and magnesium provided alongside water/calories - patients are switched to theses once intial deficit is corrected, so continuous infusion only NO BOLUS due to risk of edema

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7
Q

what are resuscitation fluids?

A

correction of life-threatening hypovolemia - fluid therapy for patients with extreme loss

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8
Q

what are crystalloid fluids?

A

solutions with electrolytes/other substances that are able to cross into all fluid compartments of the body, mainstay of resuscitation & all types of fluid therapy (normal or 0.9% saline, dextrose solutions, LRS, normosol, plasmalyte) hypertonic crystalloids: concentrations of saline greater than 0.9%, 7% hypertonic saline most commonly used in vet med

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9
Q

what are balanced solutions?

A

constituents & concentrations resemble content & osmolality of normal extracellular fluid (LRS, 0.9% saline, & 5% dextrose)

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10
Q

what are colloids?

A

molecules of high molecular weight usually proteins or carbs that are not readily able to cross cell membranes & therefore remain in the vascular space for longer durations (hetastarch, dextrans, plasma, albumin)

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11
Q

what is COP?

A

colloid osmotic pressure, pressure created by the presence of colloids in a solution that prevents movement of fluid across a semi-permeable membrane

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12
Q

what are the 2 most common colloids used in vet medicine?

A

6% hetastarch % 6% dextran

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13
Q

what changes will affect fluid flow across a capillary membrane in a patient resulting in an increased net flow into the interstitium causing edema?

A

increase in blood pressure, decrease in tissue COP, or increase in permeability

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14
Q

what is the fluid portion of the body? how is it split up?

A

60% of total body weight, 2/3 is intracellular fluid & 1/3 is extracellular fluid (4% plasma & 15% interstitial)

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15
Q

T/F: total body fluid is 60% of the total body weight

A

TRUE

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16
Q

total body water & ECF compartments are larger in what animals?

A

neonates - 70% TBW & 30% ECF

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17
Q

intravascular fluid loss is reflected by changes in what?

A

changes in cardiovascular system - heart rate, pulse strength, CRT, mucus membrane color, & body temperature

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18
Q

loss of fluids from the interstitium & intracellular areas are apparent from what clinical signs?

A

clinical signs of dehydration - loss of skin turgor, dryness of mucus membranes, & sunken eyes

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19
Q

what are the 2 questions you must start with for identification & need for treatment using fluids?

A

is there a fluid deficit & what fluids should be used for replacement

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20
Q

what lab values increase with fluid loss? what about with hypovolemia? what factors may obscure the clinical picture?

A

increase: PCV, total solids, total protein, USG, & albumin, hypovolemia: lactate & hypotension when severe - hemorrhage or protein loss may obscure the lab picture

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21
Q

T/F: in young calves with diarrhea, clinical signs correlate with dehydration & metabolic acidosis

A

TRUE

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22
Q

T/F: calves have loss of fluid & loss of HCO3 that may be severe

A

TRUE

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23
Q

hypovolemia results in a switch to what metabolism? what is seen with that?

A

switch to anaerobic metabolism - increased lactate & lactic acidosis

24
Q

what clinical signs are seen in small animals with 5-6% dehydration in regards to skin tenting, mucus membranes, CRT, & signs of shock (increased heart rate, weak pulses, & cool extremities)?

A

may see skin tenting, mucus membranes likely ok, potentially increased, not likely to see signs of shock

25
Q

what clinical signs are seen in small animals with 6-8% dehydration in regards to skin tenting, mucus membranes, CRT, & signs of shock (increased heart rate, weak pulses, & cool extremities)?

A

slow return of skin tent, mucus membranes may be dry, mild increase in CRT, less likley to see signs of shock

26
Q

what clinical signs are seen in small animals with 10-12% dehydration in regards to skin tenting, mucus membranes, CRT, & signs of shock (increased heart rate, weak pulses, & cool extremities)?

A

very slow return of skin tent, dry mucus membranes, increased CRT, & may see signs of shock

27
Q

what clinical signs are seen in small animals with 12-15% dehydration in regards to skin tenting, mucus membranes, CRT, & signs of shock (increased heart rate, weak pulses, & cool extremities)?

A

skin may not retract, very dry mucus membranes, very increased CRT, & signs of shock present

28
Q

how does body condition affect skin tenting in small animals?

A

increased tenting of skin if thin, decreased skin tenting if fat

29
Q

how is base deficit determined in a calf under 8 days old that has a base deficit of 0?

A

alert, good suckling reflex, standing/still standing but depressed

30
Q

how is base deficit determined in a calf over 8 days old that has a base deficit of -5?

A

still standing but depressed

31
Q

how is base deficit determined in a calf over 8 days old that has a base deficit of -10?

A

sternal & more depressed

32
Q

how is base deficit determined in a calf over 8 days old that has a base deficit of -15?

A

no suckle & moderate dehydration

33
Q

how is base deficit determined in a calf over 8 days old that has a base deficit of -20?

A

no suckle & severe dehydration

34
Q

how is base deficit determined in a calf under 8 days old that has a base deficit of -5?

A

weak suckle & slight dehydration

35
Q

how is base deficit determined in a calf under 8 days old that has a base deficit of -10?

A

no suckle & moderate dehydration

36
Q

how is base deficit determined in a calf under 8 days old that has a base deficit of -15?

A

lateral & extreme depression

37
Q

what calculation is used to determine fluid need in large animals?

A

horses/cows 50ml/kg/day, 100ml/kg/day in neonates

38
Q

what calculation is used to determine fluid need in small animals?

A

40-60ml/kg/day; [(BW(kg)X30) + 70] or, if under 2 kg or greater than 50 kg, use BW^0.75 X 70

39
Q

what are some examples of how animals can lose fluids?

A

gastric reflux in horses, effusions in FIP, & cows with choke with excessive salivation

40
Q

what are some pathways for fluid deficits to occur? why is this important to consider?

A

lake of intake, hemorrhage, urine loss with polyuria, respiratory (excessive panting), salivation, skin (burns, severe wounds), inflammation, & intestines - NEED TO KNOW TO DECIDE WHAT REPLACEMENT FLUIDS TO USE

41
Q

what fluids can calcium not be mixed with?

A

bicarbonate & LRS

42
Q

what animals may need dextrose added to their fluids?

A

hypoglycemia patients, neonates, toy breed dogs, & liver disease patients

43
Q

what animals may need bicarbonate added to their fluids?

A

calves with diarrhea - NOT FOR LACTIC ACIDOSIS

44
Q

what is kmax for potassium additives in fluids?

A

0.5mEq/kg/hr - enteral intake is best to correct potassium deficits

45
Q

what is the most important extracellular ion? what about most important intracellular ion?

A

extracellular: Na, intracellular: K+

46
Q

what does chloride do in acidosis? with vomiting? with abomasal obstruction?

A

in acidosis: will increase, vomiting: lost woth vomiting, & abomasal obstruction: very low

47
Q

what must also be corrected with a low calcium or low potassium?

A

must correct low magnesium!!!

48
Q

how are enteral fluids used?

A

very useful - always use if available, voluntary intake/force feeding - or feeding tubes

49
Q

when should subcutaneous administration of fluids be used for fluid therapy?

A

small animals or any species with loose skin, patients with mild deficits without signs of shock, & supplementation if not drinking well yet/with chronic disease (chronic renal failure cat)

50
Q

when should intravenous administration of fluids be used for fluid therapy?

A

any species with accessible veins (jug, cephalic, & saph most common), vital for resuscitation of severe deficits

51
Q

when should intraosseous administration of fluids be used for fluid therapy?

A

small animals/birds/reptiles/foals/neonates in very dehydrated patients or difficult to catheterize - volume & speed similar to IV

52
Q

when should intraperitoneal administration of fluids be used for fluid therapy?

A

primarily done in small lab animals - enterocentesis is a concern

53
Q

why do you want a large bore catheter for a hypovolemic animal?

A

faster flow of fluids - catheter must be smaller than vein to decrease phlebitis

54
Q

what are the shock doses used for fluid therapy?

A

80ml/kg for dogs, 50ml/kg for cats, & 8% body weight for horses/cows

55
Q

what determines how fluid moves passively between the different areas of fluids?

A

concentration gradients of large molecules (COP), sodium, & in response to hydrostatic pressure (capillary blood pressure or tissue pressure)

56
Q

what is a shock fluid dose?

A

shock dose ~ blood volume

ZUKU NAVLE PREP (178 decks)

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