Fluid Therapy 2 Flashcards
indications for IVF therapy
dehydration, electrolyte imbalance, acid/base imbalance, maintenance, deliver medication, hypotension, diuresis, toxins
abnormal losses
vomiting, diarrhea, hemorrhage, polyuria, body compartment loss (ascites, effusions)
how are fluids lost? (what happens in the cells?)
decreased profusion and hypoxia can affect how fluids move from the intravascular space (plasma) to the interstitial space (tissue)
dehydration can affect how fluids move from the interstitial space to the intracellular space
what can cause changes in fluid volumes?
hypovolemia, dehydration, hypervolemia
hypovolemia
decrease in circulating fluid volume (IVF)
dehydration
whole body fluid loss
can figure out how dehydrated from physical exam and labs
hypervolemia
excess of circulating fluid volume
fluid overload or heart disease
what causes hypovolemia?
severe dehydration, rapid blood loss, vasodilation (anaphylaxis, sepsis)
hypovolemia CS
tachycardia, bradycardia (cats), delayed CRT, pale mm, dull mentation, weak or absent pulses
dehydration physical exam signs and clinical signs
% dehydration (won’t show up until 5%), skin turgor, mm moisture/CRT, eyes, HR/pulses
dehydration lab signs
increased PCV, increased TP, increased urine specific gravity
hypernatremia
primary causes: free water deficit, excessive sodium gain
neurologic clinical signs
hyponatremia
primary causes: underlying disease (diuresis, V/D, CV, endo dz)
may not be clinically evident
hyperkalemia
primary causes: abnormal renal function, #1 urinary obstructions
has cardiac muscle effects
hypokalemia
primary causes: dietary intake, GI losses
has cardiac and skeletal muscle effects
what is a normal pH?
7.35-7.45
what roles does acid/base balance have in the body in order to regulate the body’s internal environment?
synthesize and utilize proteins, transportation of molecules, cellular integrity, essential body function to sustain life
how are hydrogen and pH related?
inversely related
low pH = acidic (increased H+)
high pH = alkalotic (decreased H+)
what does acid-base analysis give insight to?
acid-base status, ventilation, oxygenation (if arterial sample)
what are the normal values for pH, PCO2, and HCO3?
pH= 7.35-7.45
PCO2= 35-45
HCO3= 18-24
what is the most common acid-base disturbance seen in clinic?
metabolic acidosis
what should you monitor on patients receiving fluids?
mentation, HR, pulse, mm color, CRT, extremity temp, weight (1L = 1kg), lab values (PCV: 1% increase = 10 mL/kg loss), signs of fluid overload
what are signs of fluid overload?
serous nasal discharge, chemosis, edema, effusion, polyuria, tachypneic, coughing, restlessness
shock fluid rate
dog: 90 mL/kg
cat: 60 mL/kg
maintenance fluid rate
40-60 mL/kg/day
dehydration fluid formula
(% dehydrated) (weight in kg) (10)
how are ongoing losses calculated?
estimated or by weighing bedding before putting in and then weigh soiled bedding
how are shock boluses given?
entire fluids replaced
given in aliquots
