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Pharmacology II > Fluid therapy > Flashcards

Fluid therapy Flashcards

1
Q

what is the primary fluid in the body?

A

water
distributed amongst: cells, blood vessels, tissue spaces

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2
Q

where can water be found (cell wise)?

A
  1. intracellular
  2. extracellular
    -can be intravascular (within blood vessels) or interstitial (in tissue spaces between blood vessels and cells
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3
Q

how much of the body weight does water make up?

A

60% of the body weight

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4
Q

how much of the water in the body is intracellular?

A

40%
the remaining 20% is extracellular fluid and found in the plasma and in the interstitial fluid between cells

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5
Q

what do healthy animals have an equilibrium of?
(water based)

A

equilibrium between amount of water taken in and amount lost

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6
Q

what is body water made up of?

A

solutes and solvents

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7
Q

solutes

A

substances that dissolve into solvents
ex: electrolytes

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8
Q

solvents

A

what the substances dissolve into
ex: body water

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9
Q

how do you correct an imbalance of fluid or electrolytes?

A

fluid therapy

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10
Q

what is important to know about balancing body fluids?

A

fluid balance depends on electrolyte balance
when fluid volume changes, electrolyte concentration changes

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11
Q

which electrolytes are the most important in electrolyte regulation?

A

sodium and potassium

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12
Q

osmotic pressure

A

pressure/force that develops when 2 solutions of different concentrations are separated by a selectively permeable membrane

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13
Q

osmolality

A

measures the number of dissolved particles per kg of water

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14
Q

how can you determine dehydration?

A

pulse rate and quality, CRT, mm, eye position, patient history, skin turgor test

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15
Q

what are reasons why fluid would need to be administered?

A

correct electrolyte balance, promote kidney diuresis, maintain tissue/organ perfusion rate while under anesthesia, replace fluid loss, medicine

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16
Q

what are the routes for giving fluids?

A

oral: short-term, given by drinking, syringe, or nasogastric tube
SQ: used to correct mild dehydration or imbalances, 5-10 mL of fluid per lb of body weight per site
IO: via bone marrow using sterile technique and anesthesia, rapid and precise administration, useful for birds and exotics
IV: preferred for sick and/or critical patients, rapid delivery at precise dosage, requires close monitoring, higher possibility of fluid overload

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17
Q

what are the two categories of fluids?

A

crystalloids and colloids

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18
Q

crystalloid solutions

A

solutions that contain electrolytes/salts and can be with or without glucose

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19
Q

what are the different ways crystalloid solutions can be categorized?

A

isotonic, hypertonic, and hypotonic

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20
Q

hypovolemic shock

A

condition in which the liquid portion of the blood is low
can be caused by excessive vomiting, diarrhea, or blood loss

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21
Q

what are some examples of isotonic crystalloid solutions?

A

isotonic saline, LRS, normosol and plasma-lyte A or R

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22
Q

isotonic crystalloid solutions

A

same solute concentration as blood, used to replace fluid loss, similar composition as plasma, commonly used for hypovolemic shock

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23
Q

hypertonic crystalloid solutions

A

greater solute concentration than blood, have high sodium concentrations and cause water to rapidly move out of cells and into blood vessels, often used for edema and shock, work rapidly but have a short duration of action so usually used alongside colloid solutions

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24
Q

what are some examples of hypertonic crystalloid solutions?

A

0.9% normal saline with 5% Dextrose, 3% normal saline

25
Q

hypotonic crystalloid solutions

A

less solute concentration than blood, fluids with less sodium concentration than ECF, cause a portion of the fluid to move out of the intravascular space, can be used in patients who have high sodium levels or patients who can’t tolerate solutions with sodium

26
Q

what are some examples of hypotonic crystalloid solutions?

A

5% Dextrose in water, 0.25% normal saline, 0.45% normal saline

27
Q

colloid solutions

A

solutions with large molecules that stay in the vessels longer, causes fluids to pull water into the circulatory system

28
Q

oncotic pressure

A

osmotic pressure exerted by colloids in a solution
(pressure exerted by plasma proteins)

29
Q

what can colloid solutions be used to treat?

A

used for vascular space expansion, treats hypovolemic shock and hypoproteinemia (low blood protein)

30
Q

what are some examples of colloid solutions?

A

natural: plasma, albumin, whole blood
synthetic: vetstartch, hetastarch (Hydroxyethyl starch), Dextran

31
Q

whole blood

A

colloid solution
treats severe anemia/blood loss
contains RBC, WBC, platelets and plasma components of blood
collected and stored in anticogulants
good for 28-30 days
crossmatching done before use

32
Q

plasma

A

colloid solution
can be stored frozen for years
contains albumins and globulins
use within 6 hours of thawing
adverse reactions: fever, urticaria, hypotension

33
Q

albumin

A

colloid solution
main protein in blood
too much or too rapidly can cause fluid to be retained in lung vessels
adverse reactions: fever, anorexia, sudden death, 1-2 week delayed reaction can be fatal
available: lyophilized canine albumen, human albumin products

34
Q

Hydroxyethyl starch (HES)

A

synthetic colloid that expands plasma volume
derivative of amylopectin (starch that structurally resembles glycogen)
treats hypovolemic shock and hypoproteinemia
adverse reactions: urticaria, periorbital edema, dyspnea, coagulopathies
not used in patients with fluid overload, pulmonary edema, congestive heart failure

35
Q

tetrastarches (Vetstarch)

A

safer, more expensive, less adverse effects

36
Q

Dextran

A

can come in saline or dextrose
has large polysaccharides derived from sugar beets
2 concentrations: 40 and 70
expands circulating blood volume within 1 hour and effects last 24 hours or more
treats shock
adverse effects: increased bleeding time, anaphylactic reactions, development of acute renal failure, GI effects, increased blood glucose levels when metabolized

37
Q

what are crystalloid solutions commonly used for?

A

more common in GP
only 25-35% remains within intravascular space after 30 minutes of administration
great for dehydration and electrolyte imbalances

38
Q

what are colloid solutions commonly used for?

A

more common in emergency
remain in intravascular space longer
great for treating shock or critical patients
stay in vessels longer

39
Q

what should be written on a fluid bag label?

A

patient’s name, date opened, name and amount of additive, date and time of administration started, flow rate, expiration date, initials

40
Q

how fast should you give fluids?

A

rate depends on severity of dehydration, usually replaced rapidly at first then tapered to a maintenance dose
shock fluid rates are higher than maintenance fluid rates
rate of replacement of deficit depends on cardio and renal status of patient
-might need to decrease rate in cardio/renal issue patients to avoid overloading

41
Q

how are fluids usually given?

A

over 24 hour period, administered using fluid pumps that are programmed by the user to deliver fluids at a specified rate
or via drip administration sets that deliver a constant number of drops/mL of fluid

42
Q

drip administration sets

A

set has a spike to penetrate container of fluids, a drip chamber, and a long flexible tube that connects to the patient’s catheter

43
Q

how can the fluid rate be adjusted on the drip administration sets?

A

adjust rate by adjusting the diameter of the line delivering the fluids
roller clamps can be adjusted to increase or decrease amount of fluid delivered

44
Q

adult administration set rate

A

15 gtt/mL

45
Q

pediatric administration set rate

A

60 gtt/mL

46
Q

VTBI

A

volume to be infused

47
Q

PRI

A

primary rate of infusion

48
Q

Dextrose fluid additive

A

carbohydrate that corrects hypoglycemia
used for patients with high metabolic needs or anorexic patients with sepsis
not a calorie source but serves as an energy source for the brain
adverse effects: hyperosmolar syndrome (if given too fast), decreased mentation, weakness, ataxia

49
Q

potassium additive

A

necessary for contraction of smooth, cardiac, and skeletal muscles and other physiologic processes
must be consumed daily
can’t be stored in body
easily lost through kidneys and urine
supplemented to anorexic patients, fluid losses
given IV slow to avoid bradycardia

50
Q

low potassium term and signs

A

hypokalemia
signs: lethargy, muscle weakness, vomiting

51
Q

what happens if you give potassium too fast?

A

heart stops

52
Q

KCl additive

A

supplement solution used to add potassium to fluids

53
Q

sodium bicarbonate additive

A

plays a vital role in acid-base balance
added to fluids to correct metabolic acidosis
adverse effects: alkalosis, electrolyte abnormalities
needs to be given slowly
incompatible with several solutions

54
Q

signs of metabolic acidosis

A

severe shock, diabetic acidosis, severe renal disease, prolonged cardiac arrest

55
Q

calcium additive

A

necessary for functioning of nerves and muscles, clotting of blood, building of bones and teeth, and other physiologic processes
give slowly to avoid hypotension, cardiac arrhythmias, and cardiac arrest
can be given in combo with magnesium, potassium, phosphorus, and Dextrose
give IV, monitor cardiac and respiratory rate and rhythm

56
Q

what are the causes of hypocalcemia?

A

milk fever, eclampsia, endocrine disease

57
Q

what are calcium supplements?

A

calcium gluconate and calcium chloride

58
Q

why can vitamins be used as additives?

A

vitamins are lost rapidly by anorexic or debilitated animals

59
Q

what is an example of a vitamin additive?

A

vitamin B complex
frequently added to IV fluids
can cause pain SQ
sensitive to light

Pharmacology II (14 decks)

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