Fluid Administration

Question 1

Things to Measure During Fluid Administration

Answer 1

• Blood pressure
• HR
• RR
• Pulse quality
• MM
• CRT
• Measure continuously to assess effectiveness of fluid therapy and prevent fluid overload
• Excessive fluids can damage permeable membrane in the vasculature walls

Question 2

Fluid Boluses

Answer 2

• Current guidelines are boluses over 15-20 mins then reassess need for fluid therapy
• Further boluses may be needed to stabilise, before calculating plan for ongoing treatment
• The volume of fluid already given should be taken into consideration when assessing fluid deficits

Question 3

Fluid Dehydration Deficit Calculation

Answer 3

Dehydration fluid deficit (ml) = body weight (kg) x % dehydration x 1000 (ml)

• Ideally the deficit should be replaced over 12-24 hours, depending on patients disease status

Question 4

Maintenance Fluid Therapy

Answer 4

• The volume of water required for the body’s daily processes
• The recommended volume is to be delivered over 24 hours, divide the VTBI by 24 for an hourly rate

Question 5

Administering Fluids Manually

Answer 5

• Determine hourly rate
• Check the drop rate on giving set. Usually is 20 drops per ml
• Drop rate = hourly fluid rate (ml/hr) x giving set drop rate / 60 (min)

Question 6

Fluid Underload

Answer 6

• A state of reduced total body water content
• May be present after fluid therapy if water deficit or ongoing losses were miscalculated
• Continual monitoring will determine if the volume being administered is enough to restore circulating volume and restore homeostasis

Question 7

Clinical Signs of Fluid Underload

Answer 7

• Are similar to dehydration or hypoperfusion
• An underloaded patient will be hypotensive and tachycardia with poor pulse quality
• Urine output of less than 1ml/kg/hr may be indicative of fluid underload

Question 8

Fluid Overload

Answer 8

• State of excessive body water content
• Can result in pulmonary oedema or cardiac failure
• Small patients are more vulnerable due to lower blood volume and metabolic rate

Question 9

Clinical Signs of Fluid Overload

Answer 9

• Tachypnoea
• Respiratory distress
• Increased lung sounds (crackles)
• Ventral, peripheral or conjunctival oedema
• Weight gain
• Restlessness
• Coughing
• Polyuria
• Clear nasal discharge
• Diarrhoea
• Vomiting
• Exophothalmos (protrusion of eyeballs)

Question 10

Contraindications for Fluid Therapy

Answer 10

• Cardiac disease

- Hypoproteinanaemia