Fluid And Electrolyte Therapy Flashcards
Why should you give fluids during anesthesia?
Encourage perfusion
Promote blood flow
Correct ongoing losses
Counteract hypotension and vasodilation
What starling’s forces affect solutes going out of capillary (and into insterstitium)
Capillary hydrostatic pressure
Interstitial oncotic pressure
What starling’s forces affect solutes moving into capillary (out of insterstitium)
Capillary oncotic pressure
Interstitial hydrostatic pressure
What is the difference between dehydration and hypovolemia?
Dehydration: loss of WHOLE BODY water
Hypovolemia: loss of fluid from vascular compartments
What fluids may cause volume overload, coagulopathies, and renal damage?
Synthetic colloids
e.g. Hetastarch
What fluids would you give to a patient needing volume expansion and increase oxygen carrying capacity
Natural colloids
What is an appropriate maintenance fluid rate for cats, dogs, horses?
Cats: 3 ml/kg/hr
Dogs, horses: 5 ml/kg/hr
What is a good general plan for fluid therapy?
- Fix deficits: ( BW x % dehydrated) over 6 hours
- Maintenance: 3-5ml/kg/hr
- Replace ongoing losses
What is a shock dose amount of fluids?
90ml/kg
Usually will give 1/3-1/4 dose
What are two results of hemorrhagic shock?
- Hypovolemia
2. Loss of oxygen carrying capacity
What are some surrogate markers for fluid therapy?
Lactate, urine output, BP, HR
As volume returns to normal, what happens to the pulse pressure variation?
It will decrease
What electrolyte is regulated by aldosterone and catecholamines?
Na
What causes hyponatremia?
Loss of Na rich fluids
Gain of free water
What are clinical signs of hyponatremia?
Weakness and depression
You should not correct hyponatremia faster than _____ mEq/L/hr
0.5
What causes hypernatremia?
Loss of water
Decreased Na excretion
Gain of Na
What are clinical signs of hypernatremia?
Neurologic abnormalities
What effects do hyper/hyponatremia have on inhalant MAC?
Hypernatremia will increase MAC
Hyponatremia will decrease MAC
What should you give to treat chronic hypernatremia?
5% dextrose
What is the most abundant intracellular anion?
Potassium
What are clinical signs of hypokalemia?
arrhythmias, muscle weakness
Cats: cervical ventroflexion
What correcting hypokalemia, what should you do?
DO NOT correct faster than 0.5 mEq/kg/hr
Monitor ECG
If K is not improving, check Mg
What are clinical signs of hyperkalemia?
Arrhythmias, atrial standstill
ECG- tall T, loss of P, prolonged QR
How do you treat hyperkalemia?
Give Ca gluconate as cardioprotectant
Give dextrose + insulin
Furosemide, terbutaline
What are the clinical signs of hypocalcemia?
Muscle tremors/fasciculations
Seizures
Hypotension
How do you treat hypocalcemia?
Give calcium gluconate
What are clinical signs of hypercalcemia?
Vomiting
PU/PD
Abdominal pain
Weakness
How do you treat hypercalcemia?
Fluids
Ventilation?
