Fluid Therapy Flashcards
What are the 5 main functions of water in the body?
- Transportation of nutrients/oxygen
- Solvent for minerals/nutrients
- Regulation of temperature
- Flush metabolic/excretory wastes
- Moisten tissues/joints
What is the main nutritional component of the ICF, ECF and IVF?
ICF: K
ECF: Na
IVF: Protein
What maintains vital concentration gradient in terms of osmosis in the body?
Na-K pump
What effect will be observed in isotonic, hypotonic, and hypertonic solutions?
Isotonic: no effect on RBC
Hypotonic: RBC swells leading to hemolysis
Hypertonic: RBC shrinks
What is the most important protein determinant of colloid oncotic pressure?
Albumin-hypoalbuminemia will result in edema
What pressure antagonizes osmosis driving fluid outwards?
Hydrostatic pressure
T/F: Capillary wall is permeable to water, impermeable to ions and proteins?
FALSE.
Cell membrane: permeable to water and impermeable to ions
Capillary wall: permeable to water, permeable to small ions, impermeable to proteins
What do crystalloid fluids contain?
Water, electrolytes and non-electrolytes
What is the ratio of replacement for crystalloid fluids?
3:1 ratio
What are some examples of replacement crystalloid fluids?
Lactated ringers and plasmalyte R
Give examples of situations that replacement crystalloid fluids would be used.
Replace body water and electrolytes. Diarrhea, vomiting, polyuria, third space loss and dehydration
T/F: Crystalloid fluids have similar electrolyte composition to ECG with no change in electrolyte concentration
True
T/F: Crystalloid fluids contain alkanizing agents?
True: lactate, acetate and gluconate
What is an example of a maintenance crystalloid solution?
Plasmalyte M in dextrose 5%
What is the maintenance fluid requirement?
40-60 mL/kg/day
What kind of crystalloid is used for acute fluid loss?
Physiological saline (0.9% NaCl)
What kind of crystalloid solution can be used to treat cerebral edema if BBB is intact and limits accumulation of lung fluid?
Hypertonic saline (7.5% NaCl)
What is the replacement ratio of volume-blood loss for colloid fluids?
1:1 ratio
What are some examples of colloid fluids?
Hydroxyl-ethyl starch, dextran, gelatin, whole blood, plasma and albumin
What is the most commonly used colloid fluid that can alter hemostasis by decreasing factor VIII and VWF?
Hetastarch-420 kDa
Which patients would you use IV, IO, SQ or Intraperitoneal administration routes?
IV: any species
IO: small and neonatal patients
SQ: small animals with loose skin
IP: small lab animals
T/F: Largest and longest catheter is best
True
What is the standard fluid administration rate?
10 mL/kg/hr
Dogs: 5 and Cats: 3
How would you respond to a patient with acute hypotension?
Decrease anesthetic depth, administer crystalloid and colloid solutions at maintenance rate. If non-responsive after 2 boluses, consider cardio-active drugs.
If your patient was in acute hemmorhagic state but has lost less than 10% blood, how would you respond?
Crystalloids (3x lost blood volume) & colloids (exact loss of blood volume)
If your patient was in acute hemmorhagic state but has lost more than 20% blood, how would you respond?
Consider blood transfusion
