Fluid Therapy

Question 1

What are crystalloids?

Answer 1

Salt or sugar solutions without large molecules which allow them to readily cross endothelium

Question 2

What is an example of a salt cystalloid?

Answer 2

NaCl or LRS

Question 3

What is an example of a sugar crystalloid?

Answer 3

D5W

Question 4

What are colloids?

Answer 4

Natural or synthetic fluids that contain large molecules that can not cross endothelium

Question 5

What do colloids do?

Answer 5

Contribute to oncotic pressure within the vascular space so it draws fluid into the vessel

Question 6

What is shock?

Answer 6

Decreased delivery of fuel/oxygen at the cellular level, which if it persists can cause irreversible injury to cells

Question 7

What areas of the body are most affected by shock?

Answer 7

The heart, blood and cells

Question 8

What are the different types of shock?

Answer 8

• Hypovolemic
• Cardiogenic
• Obstructive
• Distributive

Question 9

What is hypovolemic shock?

Answer 9

Reduced circulation of blood volume in relation to total vascular capacity

Question 10

What is the most common type of hypovolemic shock?

Answer 10

Blood loss, but it’s not always the main reason for this condition

Question 11

What is cardiogenic shock?

Answer 11

A pump failure due to loss of contractility and/or functional myocardium

Question 12

What is SVR?

Answer 12

Systemic vascular resistance meaning the vessels are trying to constrict to compensate for loss and increase pressure

Question 13

How does cardiogenic shock effect afterload and fluid retention in the body?

Answer 13

It increases afterload with angiotension and increases fluid retention with aldosterone

Question 14

How would you treat cardiogenic shock?

Answer 14

Optimize cardiac function and treat with diuretics such as Lasix (furosamide) NO FLUIDS

Question 15

What is obstructive shock?

Answer 15

Impaired venous return such as tension pneumothorax, pericardial tamponade, or GDV

Question 16

What is distributive shock?

Answer 16

Loss of vasomotor control

Question 17

What three forms of shock are characterized by tachycardia and increased SVR?

Answer 17

Hypovolemic, cardiogenic, and obstructive

Question 18

How is distributive shock characterized?

Answer 18

Tachycardia, decreased SVR, warm extremities and bounding pulses

Question 19

Which form of shock should NOT be treated with fluid therapy?

Answer 19

Cardiogenic, and it should be used carefully in obstructive shock as not to overflow the patient which will result in an increased afterload

Question 20

What are the three phases in the treatment of shock?

Answer 20

• Phase One: Resuscitation
• Phase Two - Rehydration
• Phase Three - Maintenance

Question 21

How much fluids should be administered based on weight loss?

Answer 21

• 1 g = 1 ml

- 1 kg = 1 L

Question 22

What is the formula for maintenance fluid replacement?

Answer 22

66 ml/kg/24 hr

Question 23

Which fluid is best to treat shock?

Answer 23

Colloids because they decrease oncotic pressure, and help acute blood loos

Question 24

What is the colloid dose for shock fluid therapy?

Answer 24

• Dog: 20 ml/kg/hr

- Cat: 10-20 ml/kg/hr

Question 25

Which fluid is best to treat a dehydrated patient?

Answer 25

Crystalloids because they rehydrate the tissues not the vessels

Question 26

What is the crystalloid dose for shock fluid therapy?

Answer 26

• Dog: 80-90 ml/kg/hr

- Cat: 40-60 ml/kg/hr

Question 27

How do you determine the rehydration rate of fluids?

Answer 27

• % dehydration/100 x bw in kg = L of deficit
• L of deficit x 100 = ml of deficit
• ml of deficit/24 hr = ml/hr rehydration rate