Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

651 SA Midterm > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

Dr. Keating

1
Q

drug

A

exogenous substance that can alter physiology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

are fluids considered a drug?

A

yes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

total body water (TBW) is ____% of body weight

A

60%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What proportion of total body water is intracellular vs extracellular

A

intracellular = 2/3
extracellular = 1/3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

plasma makes up what percentage of total body water

A

5%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what composes the extracellular fluid (2)

A

interstitial (lymph, fluid between cells)
intravascular (plasma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

plasma typically compromises ___% of blood

A

~50%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

is total blood volume (mL/kg) the same across species?

A

no

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

total blood volume in cats

mL/kg

A

60 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

total blood volume in dogs

mL/kg

A

85 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

total blood volume in horses

mL/kg

A

75 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

total blood volume in cows

mL/kg

A

55 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

total blood volume in pigs

mL/kg

A

65 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

total blood volume in rabbits

mL/kg

A

55 mL/kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Is the composition and volume of fluid in different compartments FIXED or NOT FIXED?

A

NOT fixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

intracellular electrolytes

A

K⁺, Mg⁺⁺, Ca⁺⁺

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

extracellular electrolytes

A

Na⁺, Cl⁻

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

osmolality

A

number of moles of osmotically active particles per kg of water

essentially the concentration - how much water does it pull?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is osmolality dependent on:
a) size
b) weight
c) charge
d) number of particles

A

d) number of particles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

tonicity

(the consequence of osmolality)

A

measure of osmotic draw across a semi-permeable membrane

fluid moves to where there are more particles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Isotonic fluids are what osmolality

mOsm/L

A

300 mOsm/L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

hypotonic solution effect

A

pushes fluids into the cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

hypertonic solution effect

A

pulls fluids from the periphery into the bloodstream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what component of the blood is responsible for oncotic pressure?

oncotic pressure = colloid osmotic pressure (COP)

A

Proteins!

albumin is too big to leaky out of the average vessel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Do proteins contribute to the plasma osmolality?
yes, but minimally (<5%)
26
95%
27
are hypovolemia and dehydration the same thing?
no
28
hypovolemia
decreased volume in the intravascular space
29
dehydration
decreased whole body fluid/TBW
30
Is our goal in anesthesia to address hypovolemia or dehydration?
Hypovolemia! | Goal is to maintain circulating volume ## Footnote (dehydration can be fixed whenever)
31
can hypovolemia and dehydration occur together?
of course they can
32
5 Different Ways of Recognizing Fluid Deficits in our Patients
patient history physical exam laboratory tests low blood pressure pulse pressure variation
33
patient history | (in terms of fluid deficits)
diarrhea, vomiting, bleeding? volume of water consumption food/food consumption frequency/volume of urination | not super accurate but can nudge you in a certain direction
34
cardiovascular changes on physical exam that may indicate fluid deficits (2)
elevated heart rate low blood pressure
35
# Fill in the estimated percent dehydration:
36
laboratory tests | (in terms of fluid deficits)
PCV/TP USG BUN/Creatinine Blood lactate
37
PCV/TP | (in terms of fluid deficits)
high = dehydration low = anemia, hemorrhage | consider normal variations, dz processes, and RECENT hemorrhage
38
how does a recent (peracute) hemorrhage affect your analysis of PCV
takes 3-6 hours for your PCV to change due to delays in fluid shifts and splenic contractions | the spleen is a resevoir for your RBC
39
how does a recent (peracute) hemorrhage affect your analysis of TP
TP will increase more rapidly than your PCV | there isn't a resevoir for additional protein
40
what breed has a normally high PCV? | ~60
greyhounds
41
USG | (in terms of fluid deficits)
high = dehydration low = significant urinary losses
42
BUN/Creatinine | (in terms of fluid deficits)
can see a prerenal azotemia d/t decreased circulating volume | interpret alongside USG; BUN will increase first
43
Blood lactate | (in terms of fluid deficits)
hyperlactemia (>4mmol/L) can occur secondary to low circulating volume and poor tissue perfusion
44
Do all hypotensive patients need more fluids?
NO bolusing fluids in a hypotensive patient that is euvolemia will not help, and could even be detrimental
45
Explain how to check for pulse pressure variation. | This checks for decreased circulating volume!
* Give a breath to your intubated patient. * Intrathoracic pressure will increase and compress the heart and vena cava. * Euvolemic patients will be able to account for this and your blood pressure will not change. * HYPOVOLEMIC patients will have their vena cava 'squashed' by the breath --> decreasing venous return --> blood pressure DROPS * When you release the breath, the blood pressure improves again. | This can be done visually (BP trace) or audibly (Doppler).
46
positive pressure breath
inflating lungs and squishing everything | opposite of physiologic normal (negative MAKES space)
47
3 Main Categories of Fluids
Crystalloids Colloids Blood Products
48
crystalloids
aqueous solutions of mineral salts or other water soluble moelcules (like dextrose) | most common
49
3 subtypes of crystalloids
hypertonic isotonic hypotonic
50
3 Most Common Isotonic Crystalloids
Plasmalyte Normosol-R LRS
51
why is LRS being used less frequently?
LRS contains calcium which can cause certain drug interactions and cannot be used with blood products
52
~1/3
53
why is physiologic saline (0.9% NaCl) not given as a primary replacement fluid?
not balanced (only 2 electrolytes) and has proportionally more chloride than sodium which can lead to hyperchloremic acidosis
54
In waht situations do we used physiologic saline (0.9% NaCl)?
FLUSH! and rapid resuscitation
55
Isotonic crystalloids have an electrolyte composition similar to ______
extracellular fluid (ECF) | also buffered to maintain the blood pH
56
Most common hypertonic crystalloid?
hypertonic saline (7.2% NaCl) | osmolality = 2567 mOsm/L
57
physiologic normal osmolality
300 mOsm/L
58
Hypertonic Saline Uses
when rapid intravascular expansion is needed (ICF pulled into vascular space) * ER * large patients (can administer significantly less volume than isotonics for hydration effect) | example: colicky horse
59
Hypertonic Saline Cautions
unbalanced, and repeated use creates a "tolerance" per se (you will need to administer more volume for the same effect) | Mainly for your resuscitation (immediate need) situations
60
example of hypotonic crystalloid
D5W | usually given to supplement blood glucose
61
2 Categories of Colloids
naturally occurring (plasma, albumin) synthetic (hydroxyethel starches)
62
Colloid Uses
support oncotic pressure rapid volume expansion prolonged effect (molecules stay in circulation much longer)
63
complications of hydroxyethyl starches
coagulopathy kidney injury volume overload | it really "gums up" the blood
64
complications from using blood products
transfuson reactions electrolyte abnormalities volume overload hypothermia | blood comes straight from the fridge!
65
Maintenance Solution
crystalloid with an electrolyte composition matching regular losses (more K⁺ and less Na⁺ than replacement solutions)
66
Considerations in a fluid therapy plan for a Hospitalized Patient (3)
maintenance requirements dehydration status ongoing losses
67
Total Fluid Rate Equation
68
Ideal fluid rate for each species?
there isn't a fixed rate! | trick question, bitch ## Footnote (but if you were to pick one it's like 5 mL/kg/hr)
69
Signs of Fluid Overload (4)
chemosis (edema of the conjunctive) clear discahrge from the nose/ET tube limb/facial edema pulmonary edema
70
At what % loss of blood volume do we need to consider replacement in hemorrhage?
>20% total blood volume | sooner if organ disease or pre-existing anemia; assess BP and HR

651 SA Midterm (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions