Fluid Therapy Flashcards
What are some indications for fluid therapy?
Shock - low temp, increase RR
What are signs that fluid therapy is needed?
Fluid Loss
Shock
Will not eat or drink
What is the water composition of the body?
Body is 70% water
33% Extracellular 66% Intracellular
75% interstitial 25% Intravascular
Intracellular - in cell
Extracellular - intestinal and intravascular
What is the normal composition of intracellular and extracellular fluid?
Intracellular - High potassium, low sodium
Extracellular - High sodium, low potassium
What is the difference between crystalloids and colloids?
Crystalloids more likely to go into interstitial space (LRS) - salty
Colloid more likely to stay in vein (plasma) - can cause kidney damage and coagulation issues
What’s the difference between isotonic, hypotonic and hypertonic fluids?
Isotonic: same as ECF
Hypotonic: Less ECF - goes into fluid
Hypertonic: More than ECF - pulls out of intracellular fluid
What is balanced vs unbalanced fluids?
Balanced: Electrolytes similar to ECF - LRS
Unbalanced: Not balanced with ECF electrolytes - NACL 0.9
What is the difference between maintenance and replacement fluids?
Maintenance - daily low na and cl - 0.45ncal or 5% dextrose
Replacement: ECF with more na - LRS, plasmalyte
How should a bolus be administered and why would you administer one?
As fast as possible
Shock (low temp, increased RR, pale mm)
Over what time period should you administer fluids for rehydration?
12-24 hours
- slower if heart disease
-faster if azotemia
What is the typical Maintenace fluid rate?
30-60ml/kg/day (higher for smaller dog)
-Higher for neonate 80-120ml/kg/hr
What are some complications of fluid therapy?
Electrolyte imbalances
Fluid overload - pitting edema, organ damage, increase RR, GIT sign (lip licking)
Heart failure
phlebitis
extra cost
prolonged hospitalization
When should you stop fluids?
Whey they are no longer needed
-can eat and keep up with own losses
(don’t have to be drinking)
What should you ask yourself when planning for fluid therapy?
Does the patient need parental fluids? Eating and Drinking?
What type of fluids? Replacement or Maintenance
What time frame? Shock or heart disease?
How will I monitor? When do I want to stop?
You have a 4yr male castrated lab mix recovering from a gastroscopy to remove a FB. He was normotensive before the exam, no vomiting, no complications or blood loss, short surgery. Does he need parental fluids?
Nope!
Give food and bowl of water when wakes up
3yr spay DSH very painful tibial fracture. on fentanyl CRI and robenacoxib oral. Normal PCV and TS, eating and drinking, in cast. Does she need parental fluids?
No. Bowl of water
7yr spayed great dane vomiting 3 times, temp low hr high, pale, weak and lethargic, no diarrhea, normal BP. Need fluids?
Yes! Bolus LRS she is in shock!
10ml/kg fast and reassess
6 month old in-tack male DSH locked in closet 2 days. 5% dehydrated. Need fluids?
If he will eat and drink then no. Give slow in case hyponatremic
6 month old castrated AS ataxia, dull, incontinence, ate edibles. Is eating. Need fluids?
Eating so no
What are some doses for fluid calculations?
Maintenance: 30-60ml/kg/day
Replacement: % dehydrated x BW in KG = L needed
Shock 10ml/Kg IV fast (check vitals) 3 up to 3x
