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EVNS > Fluid Therapy > Flashcards

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
Q

What are the disadvantages of intravenous fluid administration?

A
  • Strict asepsis needed
  • Catheter must be monitored
  • Patient must be hospitalised
  • Risk swollen leg and overperfusion
26
Q

What are the advantages of intraosseous fluid administration?

A
  • Useful in neonates with small veins
  • Fast absorption
27
Q

What are the disadvantages intraosseous fluid administration?

A
  • Intraosseous or spinal needle required
  • Strict asepsis
  • Painful
  • Requires hospitalisation
28
Q

What is the drip factor for a standard giving set and what is its use?

A
  • 20ml
  • Colloids or crystalloids
29
Q

What is the drip factor for a paediatric giving set and what is its use?

A
  • 60ml
  • Small patients, with a burette
30
Q

What is the drip factor for a whole blood giving set and what is its use?

A
  • 15ml
  • Blood transfusions, filter chamber prevents clots entering circulation
31
Q

What is the use of a flowline balloon infuser?

A
  • Exotics
  • Small fluid volumes
32
Q

What are the 4 possible intravenous complications?

A
  • 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
Q

What are the clinical signs of phlebitis?

A
  • Swelling of vein
  • Pain
  • Redness
34
Q

What is the treatment for phlebitis?

A
  • Remove catheter
  • Vein should not be used until recovered
35
Q

What are the clinical signs of air embolism?

A
  • Temporary paralysis
  • Dyspnoea
36
Q

What is the treatment for air embolism?

A
  • Remove catheter and seal insertion site
  • Possible referral for drainage
37
Q

What are the clinical signs for thrombus formation?

A
  • Engorgement of vein
  • Swelling of area
38
Q

What is the treatment for thrombus formation?

A
  • Change the cannula
39
Q

What are the clinical signs for septicaemia bacteaemia?

A
  • Swelling
  • Redness
  • Pain
  • Discharge
  • Pyrexia
40
Q

What is the treatment for septicaemia bacteraemia?

A
  • Remove catheter
  • Clean with chlorhexidine solution
  • Antibiotics if systemic
41
Q

What are the 5 types of fluids?

A
  • Crystalloids
  • Colloids
  • Blood
  • Plasma
  • Blood
42
Q

What are crystalloids?

A
  • Fluids that contain water, electrolytes and non-electrolytes solutes
  • Can enter all body compartments
  • Used as replacement and maintenance fluids
43
Q

What are the 7 types of crystalloids used in practice?

A
  • Hartmann’s
  • Ringers solution
  • NaCl 0.9%
  • Dextrose/glucose 5%
  • 0.18% NaCl + 4% glucose
  • Hypertonic Saline 7.2% NaCl
  • Hypotonic Saline
44
Q

What is Hartmann’s?

A
  • First choice of fluids
  • Used in replacement
  • Ideal for diarrhoea, prolonged vomiting, anorexia, pyometra, hypovolaemic shock
45
Q

What is Ringers solution?

A
  • Same as Hartmann’s but without lactate
  • Ideal for severe vomiting and pyometras
46
Q

What is NaCl 0.9%?

A
  • Higher concentrations of chloride than plasma
  • Used for replacement
  • Ideal for vomiting
47
Q

What is Dextrose/Glucose 5%?

A
  • Glucose is rapidly metabolised
  • Ideal for hyperthermia, hypoglycaemia, and pure water losses
  • Not suitable for routine administrations as energy replacement for anorexic patients
48
Q

What is 0.18% NaCl +4% Glucose?

A
  • Used for maintenance
  • Ideal for hypoglycaemia or for stabilisation of the diabetic ketoacidosis patient
  • Frequent monitoring to ensure patient does not become hyperglycaemic
49
Q

What is hypertonic saline 7.2% NaCl?

A
  • 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
Q

What is hypotonic saline?

A
  • NaCl available in half strength (0.45%)
  • Used for correction of abnormalities in blood sodium concentrations
  • Ideal for hypernatremia
51
Q

What are colloids?

A

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
Q

What are the 2 colloids used in pracitce?

A
  • Gelofusine Veterinary
  • Haemaccel infusion solution
53
Q

What is fresh whole blood fluid?

A

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
Q

What is fresh plasma transfusion?

A
  • Plasma taken from fresh whole blood and frozen
  • Needs to be transfused <6 hours after thawing
55
Q

What are packed red blood cells?

A
  • 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
Q

What is oxyglobin fluid?

A
  • 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
Q

How is a drip rate calculated?

A
  • 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
Q

What is the assumption rate of lost fluids through diarrhoea and vomiting?

A
  • 4ml/kg
  • USE THIS IN CALCULATIONS
59
Q

How would you work out an assessment of fluid deficit based on losses of diarrhoea and vomit

A
  • 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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