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A. Small Animal Medicine and Surgery > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

1
Q

why is hypovolemia a problem?

A

decreased organ perfusion
ischemia
multi-organ failure

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2
Q

why is hypervolemia a problem?

A

organ dysfunction
impaired healing

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3
Q

what are insensible losses estimated to be?

A

22ml/kg/day

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4
Q

what are insensible losses?

A

immeasurable
respiratory tract and skin

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5
Q

what is hydration?

A

measure of interstitial fluid content

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6
Q

how can you asses dehydration/hydration?

A

skin turgor
moisture of mucous membranes
enophthalmos?
+/- tachycardia and collapse if severe

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7
Q

what is volume status?

A

measure of tissue perfusion

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8
Q

what are the etiologies of hypovolemic shock?

A

hemorrhage
massive fluid losses

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9
Q

what is cardiogenic shock?

A

diminished cardiac output due to decreased systolic function

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10
Q

what do you need to do if a patient is dehydrated?

A

replace interstitial deficits

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11
Q

what do you need to do if a patient is in shock?

A

improve perfusion

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12
Q

when should you consider protein losing nephropathy in a dehydrated dog?

A

azotemic
TS <5.5

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13
Q

how much weight gain does fluid overload produce?

A

> 10% from non-dehydrated baseline

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14
Q

what are some obvious signs of fluid overload?

A

peripheral edema
respiratory compromise
body cavity effusion

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15
Q

why is sodium and water retention a protective mechanism during critical illness and surgery?

A

maintaining effective circulatory volume
mitigates the systemic effects of hypovolemia

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16
Q

what can cause impaired excretion of water and be a risk factor for fluid overload?

A

heart, kidney, or liver disease
increased vasopressin release

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17
Q

what are the crystalloid fluids?

A

isotonic
hypotonic
hypertonic

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18
Q

what is a crystalloid?

A

electrolyte solution with molecules that move across semipermeable membranes

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19
Q

what are some hypotonic fluids?

A

0.45% saline
plyte-56
D5W

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20
Q

what are some indications for hypertonic saline?

A

shock treatment
head trauma

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21
Q

what are colloids?

A

solutions with molecules that are not easily able to move out of the vascular space

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22
Q

what can albumin be used to treat?

A

significant hypoalbuminemia

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23
Q

what can plasma be used to treat?

A

oncotic support when albumin transfusion is not available
replacement of clotting factors

24
Q

when can SQ fluids be useful?

A

small deficits
smaller patients

25
Q

what should your fluid therapy plan address?

A

dehydration
daily maintenance requirements
ongoing losses

26
Q

what is the maintenance fluid rate usually used for cats?

A

45 ml/kg/day

27
Q

what is the water content of pediatrics compared to adults?

A

higher water content: 80%

28
Q

what rate should you not exceed with potassium supplementation?

A

0.5 mEq/kg/h

29
Q

what is dextrose supplementation frequently needed for?

A

hypoglycemia
neonates
certain toxins

30
Q

what are the starting anesthesia fluid rates for dogs and cats?

A

dogs: 5 ml/kg/hr
cats: 3 ml/kg/hr

31
Q

what is the total intravascular fluid volume (shock dose) for dogs and cats?

A

dogs: 90 ml/kg
cats: 60 ml/kg

32
Q

what determines movement of body water?

A

hydrostatic
oncotic
osmotic

33
Q

what makes up “maintenance” requirement?

A

sensible losses: urine/feces
insensible: respiratory tract and skin

34
Q

what is shock?

A

decreased delivery of oxygen to tissues

35
Q

how can you assess shock?

A

heart rate
capillary refill time
mucous membrane color
blood pressure

36
Q

what are the types of shock?

A

hypovolemic
septic
cardiac

37
Q

what compensatory mechanisms are at play in shock to maintain blood pressure and cerebral perfusion?

A

increased heart rate
increased stroke volume
increased vascular tone

38
Q

what is the etiology of septic shock?

A

endotoxin release into systemic circulation
trigger inflammatory mediators
loss of vascular tone

39
Q

what are the etiologies of cardiogenic shock?

A

dilated cardiomyopathies
pericardial effusion
arrhythmias
myocarditis

40
Q

what should you do if you assess a patient to be in shock?

A

10-20 ml/kg IV
consider second bolus if indicated
add blood if indicated

41
Q

what is a useful sign of hypervolemia?

A

weight gain

42
Q

why does water retention occur with critical illness and surgery?

A

sodium and water retention is a protective mechanism: circulatory volume and mitigate hypovolemia effects
vasopressin release and activation of RAAS

43
Q

what are the risk factors for development of fluid overload?

A

impaired excretion of water
abnormal function of the interstitial compartment

44
Q

how does ischemia/reperfusion injury contribute to development of fluid overload in critical illness?

A

increased capillary permeability

45
Q

what are the four Ds of fluid prescription?

A

drug
dosing
duration
de-escalation

46
Q

if you’re giving replacement fluids, what should you give?

A

isotonic fluids: crystalloids

47
Q

what does it mean that a fluid is balanced?

A

contain buffer: more physiologic

48
Q

what are some indications for hypotonic fluids?

A

maintenance fluid therapy
patients with dehydration and fluid intolerance
treatment of hypernatremia

49
Q

can you use hypertonic saline in an animal that is dehydrated?

A

no

50
Q

what does giving hypertonic saline too fast cause?

A

reflex bradycardia

51
Q

is plasma an efficient way to increase albumin?

A

no

52
Q

how are subcutaneous fluids dosed?

A

up to 20 ml/kg

53
Q

how long should replacement fluids for dehydration be delivered over?

A

8-24 hours
48-72 hours for patients at risk for fluid overload

54
Q

why are fluid requirements higher for pediatrics?

A

more extracellular fluid
higher water content
higher metabolic rate
immature kidneys cannot concentrate urine

55
Q

what are the maintenance fluid rates for puppies and kittens?

A

90 ml/kg puppies
60-80 ml/kg kittens

56
Q

what rate of potassium supplementation should you not exceed?

A

0.5 mEq/kg/hr without attentive patient monitoring

A. Small Animal Medicine and Surgery (71 decks)

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