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Small A. Emergency > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

Includes SA Med fluid therapy ?s

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

What are the three fluid compartments of the body?

A

(Intracellular, interstitial, and intravascular)

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2
Q

For the listed electrolytes below, state whether they are high or low in the intracellular fluid compartment:

Sodium
Potassium

A

Sodium (low)
Potassium (high)

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3
Q

For the listed electrolytes below, state whether they are high or low in the extracellular fluid compartment:

Sodium
Potassium

A

Sodium (high)
Potassium (low)

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4
Q

What does the serum sodium concentration reflect if it does not reflect total body sodium content?

A

(It reflects total body water)

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5
Q

What does hyponatremia indicate about total body water?

A

(There is an excess of water)

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6
Q

What does hypernatremia indicate about total body water?

A

(There is a deficit of water)

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7
Q

What is dehydration?

A

(A slow process, several days to weeks, in which the body pulls water from the interstitium to replace losses in other compartments, which can be replaced slowly)

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8
Q

What is hypovolemia?

A

(A rapid loss of fluid from the intravascular space, one which requires a more rapid restoration of blood volume)

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9
Q

Why is the replacement fluid type the same for both dehydration and hypovolemia?

A

(Bc they both are losses from the same fluid compartment (extracellular))

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10
Q

(T/F) Crystalloid fluids are rapidly redistributed into the interstitium.

A

(T)

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11
Q

What are the cons of using crystalloids?

A

(You have to give a large volume, the effects are transient, and they can potentiate edema)

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12
Q

What are the cons of using colloids?

A

(Interstitial leak and edema formation, changes to coagulation (decreased vWF, VIII, platelet aggregation, and fibrin clot stability), kidney injury, and cost)

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13
Q

For the tonicity listed below, compare the salt in the fluids compared to blood:

  • Hypertonic
  • Isotonic
  • Hypotonic
A
  • Hypertonic (fluids have more salt than blood)
  • Isotonic (fluids have the same salt as blood)
  • Hypotonic (fluids have less salt than blood)
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14
Q

Of the following fluid options, state whether they are isotonic, hypertonic, or hypotonic:

  • LRS
  • Sterile water
  • Hypertonic saline
  • 0.9% NaCl
  • Normosol M
  • Normosol R
A
  • LRS (isotonic)
  • Sterile water (hypotonic)
  • Hypertonic saline (I wonder)
    -0.9% NaCl (isotonic)
  • Normosol M (hypotonic)
  • Normosol R (isotonic)
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15
Q

Why should hypotonic fluids never be bolused and only given at a slow rate (such as maintenance rate)?

A

(Bc if they are given too fast, there will be too much extracellular water so the body will shove it into the cells and the cells will burst)

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16
Q

(T/F) Hypertonic fluids pull free water from both the interstitium and the intracellular space.

A

(T)

17
Q

Hypertonic saline should be avoided in what types of patients?

A

(Patients who are dehydrated (bc now we know dehydrated means no water in the interstitium so why would you want to pull more from there) and hypernatremic patients (bc why would you want to give a patient with too much salt more salt))

18
Q

Of the following fluid options, state whether they are balanced or not:

  • LRS
  • Normosol R
  • Normal saline
  • Plasmalyte A
  • 5% dextrose in water
A
  • LRS (yes)
  • Normosol R (yes)
  • Normal saline (no)
  • Plasmalyte A (yes)
  • 5% dextrose in water (no)
19
Q

Of the following fluid options, state whether they should be used for maintenance vs. replacement:

  • LRS
  • Normosol M
  • Plasmalyte A
  • D5W
  • Normal saline
  • Half strength saline
A
  • LRS (replacement)
  • Normosol M (maintenance)
  • Plasmalyte A (replacement)
  • D5W (maintenance)
  • Normal saline (replacement)
  • Half strength saline (maintenance)
20
Q

For the following fluids, give their tonicity, whether they are balanced or not, and if they should be used for maintenance or replacement:

  • Normal saline
  • Plasmalyte A
  • D5W
  • LRS
  • Normosol R
A
  • Normal saline (isotonic, not balanced, replacement)
  • Plasmalyte A (isotonic, balanced, replacement)
  • D5W (isotonic, not balanced, maintenance)
  • LRS (isotonic, balanced, replacement)
  • Normosol R (isotonic, balanced, replacement)
21
Q

Rehydration typically is correct over 12-24 hours, faster or slower in what cases?

A

(Renal injury/azotemia and heart disease respectively)

22
Q

What is the typical range maintenance fluid rates for dogs and cats fall into?

A

(30-60 ml/kg/day, the higher the number the smaller the patient typically, 80-120 ml/kg/day for neonates/pediatrics)

23
Q

(T/F) Dyspnea is one of the later signs associated with fluid overload.

A

(T, kidneys and GIT are influenced early on in fluid overload → isosthenuria and regurg/ileus/nausea/inappetence)

24
Q

Fluids should be discontinued when a patient no longer needs them (duh) but what does that really mean?

A

(The patient can keep up with the losses they are experiencing on their own aka they are eating)

25
Q

What does it mean when a fluid is balanced?

A

(Major electrolytes are in similar proportion to that of ECF (which usually means lower in chloride))

26
Q

If replacement fluids mimic extracellular fluid, that means sodium will be high/low (choose).

A

(High; maintenance mimics daily electrolyte needs so lower in NaCl and higher in K)

27
Q

(T/F) Oral fluids are best whenever that is possible.

A

(T, IV is next best if PO not available)

28
Q

(T/F) Anything you give IV can be given IO.

A

(T)

29
Q

Subq fluids are only appropriate in what types of patients?

A

(Stable patients)

30
Q

What is the crystalloid dose for a shock fluid bolus?

A

(10-20 ml/kg given as fast as possible)

31
Q

What is the colloid dose for a shock fluid bolus?

A

(5-10 ml/kg given as fast as possible)

32
Q

What is the hypertonic saline dose for a shock fluid bolus?

A

(4-6 ml/kg given as fast as possible in the appropriate patients)

33
Q

You should aim to use the largest/smallest (choose) bore and longest/shortest (choose) length catheter as possible when bolusing fluids.

A

(Largest bore, shortest length)

34
Q

Pair the following quick maintenance rate estimates with the appropriately sized animal:

  • 40 ml/kg/day
  • 50 ml/kg/day
  • 60 ml/kg/day
  • 80-100 ml/kg/day
A
  • 40 ml/kg/day (Large to giant breed dogs)
  • 50 ml/kg/day (Medium dogs and cats)
  • 60 ml/kg/day (Small dogs)
  • 80-100 ml/kg/day (Neonates)
35
Q

What are some possible complications of fluid therapy?

A

(Electrolyte imbalances, fluid overload (pitting or organ edema), phlebitis, iatrogenic congestive heart failure, extra costs, prolonged hospitalization)

36
Q

Give the appropriate ml/kg/hr rate for the following potassium supplementation goals:

  • Maintenance
  • Mild to moderate hypokalemia
  • Moderate to severe hypokalemia
A
  • Maintenance (0.05-0.1 ml/kg/hr)
  • Mild to moderate hypokalemia (0.15-0.25 ml/kg/hr)
  • Moderate to severe hypokalemia (0.3-0.5 ml/kg/hr)
37
Q

Your patient has mild to moderate hypophosphatemia, what ml/kg/hr rate do you want to put them on to supplement them?

A

(0.01-0.03 mmol/kg/hr, higher as needed)

38
Q

You want to give a patient a bolus of magnesium over 30 minutes, what is the appropriate dose range in mEq/kg?

A

(0.15-0.3 mEq/kg)

39
Q

What is an appropriate mEq/kg/hr rate for maintenance of magnesium?

A

(0.02-0.04 mEq/kg/hr or 0.5-1 mEq/kg/day)

Small A. Emergency (16 decks)

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