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X PPPVN > Fluid Therapy > Flashcards

Fluid Therapy Flashcards

1
Q

define osmosis

A

the movement of water across a semi-permeable membrane from high water activity to low water activity

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2
Q

define osmolality

A

the concentration of a solution expressed as the total number of solute particles per litre

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3
Q

what are electrolytes?

A

minerals dissolved into ions

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4
Q

define tonicity

A

the measure of osmotic pressure of two solutions separated by a semi permeable membrane

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5
Q

define isotonic

A

two solutions have the same concentration of impermeable solutes

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6
Q

define hypotonic

A

the solution contains a lower concentration of impermeable solutes than the body (cell) fluid so will move into the body (cell) and can cause lysis

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7
Q

define hypertonic

A

the solution contains a higher concentration of impermeable solutes than the body (cell) fluid so will draw water out of body (cell) tissues

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8
Q

name 2 examples of a normal fluid intake

A

eating and drinking

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9
Q

name 2 examples of normal fluid outgoing

A

urination and defecation

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10
Q

name 2 examples of abnormal fluid intake

A

water deprivation and anesthesia

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11
Q

name 2 examples of abnormal fluid outgoing

A

vomiting and haemorrhage

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12
Q

what may fluid loss be caused by?

A

dehydration and hypovolaemia

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13
Q

what are two other potential causes of fluid imbalance?

A

electrolyte imbalance and altered fluid distribution (change in oncotic pressures e.g. loss of albumin)

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14
Q

define dehydration

A

loss of fluid from extravascular space

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15
Q

what would be the clinical findings of 0-4% dehydration?

A

none (very few)

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16
Q

what would be the clinical findings of 4-6% dehydration?

A

tacky mucous membranes

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17
Q

what would be the clinical findings of 6-8% dehydration?

A

loss of skin turgor (skin tent becomes less elastic), dry mucous membranes

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18
Q

what would be the clinical findings of 8-10% dehydration?

A

loss of skin turgor (skin tent becomes less elastic), dry mucous membranes, sunken eyes

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19
Q

what would be the clinical findings of 10-12% dehydration?

A

persistant skin tent, dry mucous membranes, retracted globe, dull corneas, pulse deficits (hypovolaemia)

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20
Q

define hypovolaemia

A

reduction in blood volume or fluid in the intravascular space

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21
Q

what are the clinical signs of mild (compensated) hypovolaemia?

A

mild tachycardia, pinker than normal mucous membranes, increased (<1 second) capillary refill time, bounding pulse

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22
Q

define compensating/compensated

A

patients body is able to correct fluid loss using normal physiological processes (e.g. vasoconstriction, increased HR)

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23
Q

define decompensated/decompensating

A

body is unable to keep up and maintain fluid volume

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24
Q

what are the clinical signs of severe (decompensated) hypovolaemia?

A

severe tachycardia, white/grey mucous membranes, >2seconds (prolonged) capillary refill time, poor/thready pulse

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25
Q

how does the presentation of severe (decompensated) hypovolaemia differ in cats?

A

causes bradycardia not tachycardia

26
Q

what are crystalliod fluids?

A

solutions which contain diluted minerals known as electrolytes

27
Q

what are the 3 main types of crystalloid fluids?

A

replacement
maintenance
hypertonic

28
Q

give 3 examples of replacement crystalloid fluids

A

Hartmann’s
Lactated Ringers
0.9% NaCl (normal saline)

29
Q

what is the tonicity of replacement crystalloid fluids compared to ECF?

A

isotonic - they will not cause any fluid movement and so increase the volume of intravascular space and ECF

30
Q

give an example of maintenance crystalloid fluids

A

0.45% NaCl + 2.5% dextrose

31
Q

what is the tonicity of maintenance crystalloid fluids, such as 0.45% NaCl + 2.5% dextrose, compared to ECF?

A

hypotonic - fluid will move into the intracellular space

32
Q

how does 0.45% NaCl + 2.5% dextrose avoid the issue of cell lysis associated with hypotonic solutions?

A

the solution remains isotonic until the dextrose is metabolised when it then becomes hypotonic. Shortens time cells are exposed to hypotonic solution

33
Q

give an example of a hypertonic crystalloid fluid

A

7.2% NaCl (hypertonic saline)

34
Q

what is the effect on cells of hypertonic saline (7.2% NaCl)?

A

pulls fluid from ICF into intravascular space

35
Q

when must hypertonic saline (7.2% NaCl) be avoided?

A

dehydration due to its likelihood to worsen it

36
Q

when can hypertonic saline (7.2% NaCl) be used effectively?

A

resuscitation of hypovolaemic cases

37
Q

what are colloids?

A

large molecules that increase the oncotic pressure of plasma and so hold fluid in the intravascular space and increase volume

38
Q

what are colloids introduced in?

A

fluid

39
Q

when are colloids useful?

A

hypovolaemia

40
Q

give 2 synthetic/artificial colloids

A

dextrans and gelatins

41
Q

what are natural colloids?

A

blood products, frozen plasma or whole blood

42
Q

what are the 5 methods of administration of fluids?

A

intravenous, subcutaneous, intra-osseus, oral, intraperitoneal

43
Q

which is the most common method of fluid administration?

A

IV - fast acting and large volumes

44
Q

when is subcutaneous most useful?

A

mild dehydration or feline kidney disease

45
Q

when is intra-osseus fluid given?

A

in puppies or kittens where their vessels are small and may be collapsed if dehydrated

46
Q

what is the issue with oral administration of fluids?

A

relies on the patient drinking

47
Q

when are intraperitoneal fluids given?

A

to small furries

48
Q

what are the slowest acting methods of fluid administration?

A

sub-Q and intraperitoneal

49
Q

what are the 5 Rs of a fluid plan?

A 
resuscitation
routine maintenance
replacement
redistribution
re-assessment
50
Q

what is the amount of fluids required for routine maintenance?

A

50ml/kg/day

51
Q

what are the 3 most common types of giving set?

A

standard, pediatric burette, blood giving

52
Q

what is the difference between a standard giving set and a paediatric burette?

A

paediatric burette is smaller and offers much more control

53
Q

what does a blood giving set have that others do not?

A

filter to trap blood clots

54
Q

what differs between giving sets?

A

drip factors

55
Q

how should dehydration deficit be calculated?

A

dehydration deficit = %dehydration x BW(kg) x 10

56
Q

how should ongoing losses be calculated?

A

ongoing losses = 4ml x number of vomit/diarrhea episodes x BW(kg)

57
Q

what is the maintenance of fluid calculation?

A

maintenance = 50 ml/kg/day x BW(kg)

58
Q

how should a patients fluid requirement over 24 hours be calculated?

A

sum of:

dehydration deficit, ongoing losses and maintenance

59
Q

how can we convert fluid requirement over 24 hours to drip rate?

A

convert total fluid requirement over 24 hours to ml/min by dividing by 24 (hours) and then 60 (minutes).

60
Q

how should drops per minute be calculated from m per minute?

A

drops per minute = millilitres per minute x giving set factor

61
Q

what is the usual value of a giving set factor?

A

20 or 60

62
Q

how is the final drip rate (seconds/drop) calculated from drops per minute?

A

drip rate = 60 /drops per minute

X PPPVN (27 decks)

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