fluid therapy Flashcards
general principles of fluid therapy
- Maintenance Fluids- replacement for normal losses via
urine, feces, respiratory tract and skin. - Current deficit to replace dehydration-is an estimate.
- Continuing losses-occurring
over a 24 hour period in addition to maintenance requirement
function of body fluids
preventing dehydration, hypovolemia, and hypotension and further extreme effects
general principles of fluid therapy during anesthesia
2.5 – 5 ml/kg/ hr cats
5 – 10 ml/kg/hr dogs
Indicate the factors used in patient assessment prior to fluid therapy
skin tent, eyes, mouth
isotonic
balanced electrolyte solutions; shock dose fluids
hypotonic
lower concentration of dissolved solutes than blood
hypertonic
higher concentration of solute; given with isotonic
isotonic osmolality
the liquid has the same osmotic pressure as human blood
examples of isotonic solutions
LRS, Plasmalyte, Normosol R
When given a fluid, indicate whether it is isotonic, hypotonic or hypertonic
0.9% normal saline does not have K or Ca
fluid therapy rate used during anesthesia at Parkland College
5 - dogs
2.5 - cats
2 fluid administration systems
drip sets
IV pumps
importance of IV administration considerations
- IV bages labeled
- frequent monitoring
- new bag and line for each patient
- flush catheter every 6-8 hours
- aseptic technique
- slowly
- warm fluids
clinical signs seen when fluid therapy is under-administrated and over-administrated
Increased respiratory rate and effort (>20% increase)
Watery nasal discharge
Chemosis (eyelid swelling)
Pitting Edema
Restlessness
Coughing
course of treatment used for hypotension during anesthesia
- 1st assess anesthetic depth
- If too deep – decrease anesthetic depth; Give IV bolus of crystalloid at 3 – 10 ml/kg
- Repeat once if needed
- If slow to respond, consider IV colloid
- If not response, consider medication
effects of dehydration
can lose nearly all its glycogen
and fat, half its protein and 2/5 of its body weight; metabolic disturbances and shock
calculation for maintenance fluid replacement
40-60 mL/kg/day
40- large
60- small
physical indicators of dehydration seen on a physical exam
Acute weight change, skin elasticity, dry mucous
membranes, sunken eyeballs, delayed CRT (>2 secs)
clinical evaluation of fluid loss
PCV-increased (unless blood loss)
TP-increased (unless blood loss)
BUN-elevated to 20 or more.
Creatinine - no change with dehydration
Urine SG - should be above 1.020 if dehydrated; isosthenuria in the face of dehydration suggests renal failure.
Hypokalemia - secondary to vomiting/ diarrhea. Can add KCl
to fluids if needed.
different types of fluids and fluid additives used
dextrose
potassium
sodium bicarbonate
5 common routes of fluids and discuss the advantages and disadvantages of each route
IV- shock, emergency, dehydration, hypovolemia, hypotension, electrolyte imbalance, fast absorption; can be given too quickly
IO- if IV isn’t possible, younger patients, rapid dispersion; short term, infection at site, osteomyelitis
IP- neonates, IV not available; slow absorption, peritonitis, intra-abdominal abscess
SQ- large volumes, cost effective; slow absorption, can’t be used for hypovolemic, hypotensive, severely dehydrated patients
PO- large animal, cost effective, tonicity doesn’t matter; not used for shock
IV flow rate for shock
Dogs – start bolus at 20 ml/kg over 15 minutes
Cats – start bolus at 10 ml/kg over 15 minutes
