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Fluid Therapy Flashcards

1
Q

How much water makes up the total body weight?

A

60%

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2
Q

What are the normal water intakes?

A
  • Ingestion
  • Metabolism
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3
Q

What are the normal water losses?

A
  • Kidneys
  • GI tract
  • RT
  • Skin
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4
Q

What is the normal maintenance fluid requirement?

A
  • 50ml/kg/day or 2ml/kg/hr
  • USE THIS FOR FLUID CALCULATIONS
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5
Q

What are the indications for fluid therapy?

A
  • Increased urine production
  • Diarrhoea and vomiting
  • Excessive panting
  • Effusions
  • Burns/open wounds
  • Blood loss
  • Hypovolaemic shock
  • Perioperative losses
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6
Q

What are the 4 types of fluid loss?

A
  • Pure water loss
  • ECF loss
  • Whole blood loss
  • Protein rich ECF
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7
Q

What is pure water loss?

A
  • No electrolyte changes
  • Seen with tachypnoea, pyrexia and pneumonia
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8
Q

What is ECF loss?

A
  • Water and electrolyte loss
  • Seen with vomiting and diarrhoea
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9
Q

What is whole blood loss?

A

Haemorrhage

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10
Q

What is protein rich ECF?

A
  • Water, electrolytes and proteins are lost
  • Seen with protein losing diseases, burns and effusions
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11
Q

Why is fluid therapy used?

A
  • Correct dehydration
  • Resolves acidosis and alkalosis
  • Replenish electrolyte deficiencies
  • Provide nutrition
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12
Q

How is hydration assessed?

A
  • History
  • Clinical examination
  • Laboratory analysis
  • Clinical measurements
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13
Q

What are the clinical signs of a <5% water deficit?

A
  • Polyruria
  • Polydipsia
  • No clear clinical signs
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14
Q

What are the clinical signs of a 5-7% water deficit?

A
  • Subtle loss of skin skin elasticity
  • Increased CRT
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15
Q

What are the clinical signs of a 7-10% water deficit?

A
  • Sunken eyes
  • Skin tent remains in place
  • Anuria
  • Depression
  • Weak pulse
  • Dry MMs
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16
Q

What are the clinical signs of a 10-12% water deficit?

A
  • Progression of shock
  • Comatose
  • Death
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17
Q

What are the 5 different routes of fluid administration?

A
  • Oral (per os)
  • Subcutaneous (s/c)
  • Intraperitoneal (i/p)
  • Intravenous (i/v)
  • Intraosseous (i/o)
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18
Q

What are the advantages of oral fluid administration?

A
  • Simple
  • Cheap
  • Non-invasive, so can be done at home
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19
Q

What are the disadvantages of oral fluid administration?

A
  • Very slow
  • Limited range of suitable fluids
  • Not suitable if animal is vomiting
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20
Q

What are the advantages of subcutaneous fluid administration?

A
  • Simple
  • Can be done at home such as CDC in cats
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21
Q

What are the disadvantages of subcutaneous fluid administration?

A
  • Slow absorption
  • Limited volume
  • Some discomfort
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22
Q

What are the advantages of intraperitoneal fluid administration?

A
  • Faster uptake than s/c
  • Good when IV line not possible e.g., small furries
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23
Q

What are the disadvantages of intraperitoneal fluid administration?

A
  • Limited volume
  • Care with abdominal organs
  • Asepsis needed
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24
Q

What are the advantages of intravenous fluid administration?

A
  • Fast rates
  • High volumes of fluid can be given
  • Rapid correction of deficits
  • Wide range of fluid options
  • Choice of veins
25
What are the disadvantages of intravenous fluid administration?
- Strict asepsis needed - Catheter must be monitored - Patient must be hospitalised - Risk swollen leg and overperfusion
26
What are the advantages of intraosseous fluid administration?
- Useful in neonates with small veins - Fast absorption
27
What are the disadvantages intraosseous fluid administration?
- Intraosseous or spinal needle required - Strict asepsis - Painful - Requires hospitalisation
28
What is the drip factor for a standard giving set and what is its use?
- 20ml - Colloids or crystalloids
29
What is the drip factor for a paediatric giving set and what is its use?
- 60ml - Small patients, with a burette
30
What is the drip factor for a whole blood giving set and what is its use?
- 15ml - Blood transfusions, filter chamber prevents clots entering circulation
31
What is the use of a flowline balloon infuser?
- Exotics - Small fluid volumes
32
What are the 4 possible intravenous complications?
- Phlebitis (inflammation which causes a blood clot in the vein) - Air embolism (air in the vascular system) - Thrombus formation (Platelets forming) - Septicaemia bacteraemia (Inflammation throughout the body, which cause blood clots and blocks oxygen to vital organs)
33
What are the clinical signs of phlebitis?
- Swelling of vein - Pain - Redness
34
What is the treatment for phlebitis?
- Remove catheter - Vein should not be used until recovered
35
What are the clinical signs of air embolism?
- Temporary paralysis - Dyspnoea
36
What is the treatment for air embolism?
- Remove catheter and seal insertion site - Possible referral for drainage
37
What are the clinical signs for thrombus formation?
- Engorgement of vein - Swelling of area
38
What is the treatment for thrombus formation?
- Change the cannula
39
What are the clinical signs for septicaemia bacteaemia?
- Swelling - Redness - Pain - Discharge - Pyrexia
40
What is the treatment for septicaemia bacteraemia?
- Remove catheter - Clean with chlorhexidine solution - Antibiotics if systemic
41
What are the 5 types of fluids?
- Crystalloids - Colloids - Blood - Plasma - Blood
42
What are crystalloids?
- Fluids that contain water, electrolytes and non-electrolytes solutes - Can enter all body compartments - Used as replacement and maintenance fluids
43
What are the 7 types of crystalloids used in practice?
- Hartmann's - Ringers solution - NaCl 0.9% - Dextrose/glucose 5% - 0.18% NaCl + 4% glucose - Hypertonic Saline 7.2% NaCl - Hypotonic Saline
44
What is Hartmann's?
- First choice of fluids - Used in replacement - Ideal for diarrhoea, prolonged vomiting, anorexia, pyometra, hypovolaemic shock
45
What is Ringers solution?
- Same as Hartmann's but without lactate - Ideal for severe vomiting and pyometras
46
What is NaCl 0.9%?
- Higher concentrations of chloride than plasma - Used for replacement - Ideal for vomiting
47
What is Dextrose/Glucose 5%?
- Glucose is rapidly metabolised - Ideal for hyperthermia, hypoglycaemia, and pure water losses - Not suitable for routine administrations as energy replacement for anorexic patients
48
What is 0.18% NaCl +4% Glucose?
- Used for maintenance - Ideal for hypoglycaemia or for stabilisation of the diabetic ketoacidosis patient - Frequent monitoring to ensure patient does not become hyperglycaemic
49
What is hypertonic saline 7.2% NaCl?
- Special type of replacment fluid, as high sodium level causes water to be drawn out of cells - Bolus given over 5 minutes - Must be followed with isotonic crystalloids to rehydrate cells - Ideal in hypovolaemia not caused by normal bleeding such as GDV - Should not be used in dehydrated patients
50
What is hypotonic saline?
- NaCl available in half strength (0.45%) - Used for correction of abnormalities in blood sodium concentrations - Ideal for hypernatremia
51
What are colloids?
Fluids containing gelatines that are used when crystalloids will not be sufficient to support circulation e.g., severe shock, severe dehydration, PCV <20% due to haemorrhage and plasma protein <35g - Stay in circulation longer than crystalloids
52
What are the 2 colloids used in pracitce?
- Gelofusine Veterinary - Haemaccel infusion solution
53
What is fresh whole blood fluid?
Fluid that contains RBC's, WBC's, platlets, clotting factors and plasma proteins - Should be used in 6 hours, as platelets and clotting factors rapidly inactivate and reduces chances of bacterial colonisation - Important to cross match cats and dogs
54
What is fresh plasma transfusion?
- Plasma taken from fresh whole blood and frozen - Needs to be transfused <6 hours after thawing
55
What are packed red blood cells?
- RBC's used for severe anaemia and acute haemorrhage - Given concurrently with 9.9% NaCl on apiggy back system to ensure all RBC's are given and not left in the giving set to reduce viscosity
56
What is oxyglobin fluid?
- Large molecules of oxyglobin which combine with oxygen and carbon dioxide - Does not require cross matching - Alternative to whole blood if problems are related to oxygen carry capacity - Expensive
57
How is a drip rate calculated?
- Hourly maintenance (2ml) x weight (kg) = .... (ml/hr) - ..... (ml/hr) / hour (60 min) = ...... (ml/min) - Fluid per minute (ml/min) x drip factor per min= .... drops/min - If asks for drops/sec, then 60 (min)/ ..... drops/min= drips/secs - The use have your drip rate : .... drop every 10 seconds
58
What is the assumption rate of lost fluids through diarrhoea and vomiting?
- 4ml/kg - USE THIS IN CALCULATIONS
59
How would you work out an assessment of fluid deficit based on losses of diarrhoea and vomit
- Weight (kg) x assumption rate of losses (4ml) = ..... ml - Number of times a day x ..... ml - Number of days x ....... ml = ...... ml total fluid deficit

EVNS (10 decks)

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