Fluid Therapy

Question 1

What are the 5 main functions of water in the body?

Answer 1

1. Transportation of nutrients/oxygen
2. Solvent for minerals/nutrients
3. Regulation of temperature
4. Flush metabolic/excretory wastes
5. Moisten tissues/joints

Question 2

What is the main nutritional component of the ICF, ECF and IVF?

Answer 2

ICF: K
ECF: Na
IVF: Protein

Question 3

What maintains vital concentration gradient in terms of osmosis in the body?

Answer 3

Na-K pump

Question 4

What effect will be observed in isotonic, hypotonic, and hypertonic solutions?

Answer 4

Isotonic: no effect on RBC
Hypotonic: RBC swells leading to hemolysis
Hypertonic: RBC shrinks

Question 5

What is the most important protein determinant of colloid oncotic pressure?

Answer 5

Albumin-hypoalbuminemia will result in edema

Question 6

What pressure antagonizes osmosis driving fluid outwards?

Answer 6

Hydrostatic pressure

Question 7

T/F: Capillary wall is permeable to water, impermeable to ions and proteins?

Answer 7

FALSE.
Cell membrane: permeable to water and impermeable to ions
Capillary wall: permeable to water, permeable to small ions, impermeable to proteins

Question 8

What do crystalloid fluids contain?

Answer 8

Water, electrolytes and non-electrolytes

Question 9

What is the ratio of replacement for crystalloid fluids?

Answer 9

3:1 ratio

Question 10

What are some examples of replacement crystalloid fluids?

Answer 10

Lactated ringers and plasmalyte R

Question 11

Give examples of situations that replacement crystalloid fluids would be used.

Answer 11

Replace body water and electrolytes. Diarrhea, vomiting, polyuria, third space loss and dehydration

Question 12

T/F: Crystalloid fluids have similar electrolyte composition to ECG with no change in electrolyte concentration

Answer 12

True

Question 13

T/F: Crystalloid fluids contain alkanizing agents?

Answer 13

True: lactate, acetate and gluconate

Question 14

What is an example of a maintenance crystalloid solution?

Answer 14

Plasmalyte M in dextrose 5%

Question 15

What is the maintenance fluid requirement?

Answer 15

40-60 mL/kg/day

Question 16

What kind of crystalloid is used for acute fluid loss?

Answer 16

Physiological saline (0.9% NaCl)

Question 17

What kind of crystalloid solution can be used to treat cerebral edema if BBB is intact and limits accumulation of lung fluid?

Answer 17

Hypertonic saline (7.5% NaCl)

Question 18

What is the replacement ratio of volume-blood loss for colloid fluids?

Answer 18

1:1 ratio

Question 19

What are some examples of colloid fluids?

Answer 19

Hydroxyl-ethyl starch, dextran, gelatin, whole blood, plasma and albumin

Question 20

What is the most commonly used colloid fluid that can alter hemostasis by decreasing factor VIII and VWF?

Answer 20

Hetastarch-420 kDa

Question 21

Which patients would you use IV, IO, SQ or Intraperitoneal administration routes?

Answer 21

IV: any species
IO: small and neonatal patients
SQ: small animals with loose skin
IP: small lab animals

Question 22

T/F: Largest and longest catheter is best

Answer 22

True

Question 23

What is the standard fluid administration rate?

Answer 23

10 mL/kg/hr

Dogs: 5 and Cats: 3

Question 24

How would you respond to a patient with acute hypotension?

Answer 24

Decrease anesthetic depth, administer crystalloid and colloid solutions at maintenance rate. If non-responsive after 2 boluses, consider cardio-active drugs.

Question 25

If your patient was in acute hemmorhagic state but has lost less than 10% blood, how would you respond?

Answer 25

Crystalloids (3x lost blood volume) & colloids (exact loss of blood volume)

Question 26

If your patient was in acute hemmorhagic state but has lost more than 20% blood, how would you respond?

Answer 26

Consider blood transfusion