Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Large Animal Surgery > Fluid Therapy in Equine Patients > Flashcards

Fluid Therapy in Equine Patients Flashcards

1
Q

What are the 5 levels of dehyrdation? What is seen at each stage?

A
  • <5% = NSF
  • 5% = dry/tacky membranes, mild depression
  • 7% = moderate skin tent, tachycardia, slow jugular refill
  • 10% = moderate to marked skin tent, decreased pulse pressure, cold extremities, depressed
  • 12% = marked skin tent, signs of shock, obtundation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Estimating volume loss:

A

CRT not as sensitive in eqiune patients

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 goals of fluid therapy?

A
  1. restore intravascular volume
  2. improve tissue perfusion
  3. overcome regional circulatory deficiency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When is the emergency phase of fluid therapy recommended? What doses are used? In foals?

A

10-12% dehydration —> shock!

  • shock dose of 60-90 mL/kg
  • 1/4 to 1/3 dose and reasses
  • 10-20 L bolus

1L bolus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is replacement fluid therapy? How is deficit volume calculated?

A

deficit + maintainence + continuing loss

% dehydration x BW (kg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What maintaining fluids are used in adult and foals?

A

2-4 mL/kg/hr

3-5 mL/kg/hr (including oral!)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

A 400 kg horse presents for diarrhea nad is assessed to be 8% dehydrated. What is the fluid deficit?

A

0.08 x 400 kg = 32 L fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the general 24-hour plan for approaching fluid therapy?

A
  • FIRST HOUR = fluid bolus to address shock
  • 3-4 HOURS = address replacement and ongoing loses with 50% deficit
  • NEXT 12 HOURS = address remaining deficit
  • REST = address maintenance and losses

monitor and reassess after 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

A 400 kg horse presents for diarrhea nad is assessed to be 8% dehydrated. Make a fluid plan for this horse over the next 24 hours.

A

0.08 x 400 kg = 32 L fluids to address deficit

  • FIRST BOLUS OF 50% over 3 hours = 32L x 0.5 = 16 L
  • 16 L left to give over 12 hours = 16L/12hr = 2.3 L/hr
  • MAINTENANCE = 60 mL/kg/day x 400 kg = 24 L/day = 1 L/hr
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 3 most common sites for IV catheter locations in horses for fluids?

A
  1. jugular*
  2. lateral thoracic
  3. cephalic - hard to maintain large amounts of ongoing fluids

14 g IVC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 2 types of IV catheters?

A
  1. over the needle - short, Abbocath (polyurethane made for short-term 24-48 hrs), Mila (polytetrafluoroethylene for long-term up to 14 days)
  2. over the wire - Sialastic = flexible, common in foals with 1-2 lumens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What type of extension set is recommended for IV fluids set up in horses?

A

larger bore —> too small = rate limiting

  • recommended to wrap in horses, older ones tend to leave them alone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the difference between administration and transfer sets?

A

ADMINISTRATION = “stat” set, has coil to allow movement of horse, attaches 2 bags

TRANSFER = connects up to 4 fluid bags

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How are administration sets attached?

A
  • braided into horses mane
  • attached to catheter
  • hangs 2-4 5L bags = 10-20 L total
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Crystalloid fluids, composition:

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What 3 fluids are most commonly used for rehydration?

A
  1. Normosol-R
  2. Plasma-Lyte
  3. LRS (+maintenance)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What use does 0.9% NaCl have?

A
  • hyperkalemia
  • hyponatremia
  • hypochloremia
18
Q

What use does 0.45% NaCl and 2.5% dextrose have?

A
  • neonates
  • hypernatremia
19
Q

What use does 5% dextrose have?

A

water deficit

20
Q

What are the 3 most common uses of hypertonic saline?

A
  1. rapid, transient increase in blood volume - 4x normal dose, shorter duration (45 mins), depletes intracellular volume
  2. increase BP, and CO/O2 delivery
  3. decreased ischemic/reperfusion injury
21
Q

How can the intracellular fluid deficit caused by hypertonic fluid administration be corrected?

A

administer 10L of isotonic fluid per L of hypertonic fluid

22
Q

What 3 actions do colloids have? What are the 3 major indications?

A
  1. restores effective circulating volume
  2. supports oncotic pressure (albumin!)
  3. expands plasma volume
  • TP < 4 mg/dL
  • albumin < 3 mg/dL
  • COP < 12 mmHg
23
Q

What is the purpose of administering plasma? How is it used?

A

source of albumin and clotting factors (COP = 20 mmHg)

10 L plasma required to increase TP by 1.0 g/dL

24
Q

How is the amount of plasma to be administered calculated?

A

0.05 x BW x ([desired TP - patient TP]/donor TP)

25
Q

What are some synthetic colloids? What 2 actions does it have? What does it not affect?

A

hetastarch or pentastarch 6% solution in isotonic saline (COP = 30-37 mmHg)

  1. increases vascular space (by 141%) for 12-48 hrs
  2. increases COP

TP does not increase

26
Q

What dose of synthetic colloids are recommended? In what situations are they used?

A

10-20 mL/kg

  • platelet dysfunction
  • renal injury
27
Q

What clinical signs should be observed with successful fluid therapy?

A
  • HR normalization
  • increased pulse quality
  • improved mentation
  • decreased CRT
  • increased urine production
  • warming extremities
28
Q

What lab work should be monitored with fluid therapy?

A
  • PCV/TS
  • USG (neonates)
  • blood serum lactate - indicative of oxygen consumption by tissue and perfusion (< 2 mmol/L)
  • electrolytes - fluids are not complete (especially if on fluid for > 24 hrs)
29
Q

How important are electrolyte disturbances in fluid therapy? What are the 2 most important disturbances that should be corrected?

A

unless severe deficit, not crucial part of therapy

  1. hypocalcemia - cantharidin toxicity, thumps
  2. hypoglycemia - septicemia, NMS in foals
30
Q

What are the 3 major actions of calcium?

A
  1. skeletal muscle contraction
  2. neuronal function
  3. GI smooth muscle function
31
Q

What are 4 causes of hypocalcemia? How is it treated?

A
  1. endotoxemia
  2. functional SI disturbances
  3. common in endurance horses
  4. postpartum dairy cattle

50-100 mL or 500 mL 23% calcium gluconate

32
Q

What is the normal distribution of potassium? What are the 2 most common signs of hypokalemia? How is it treated?

A

<2% in ECF (mostly intracellular) —> extracellular shift possible

  1. reduced intestinal motility
  2. muscle weakness, lethargy

0.5 mEq/kg/hr or 10-20 mEq/L = 50-100 mEq/5 L bag

33
Q

How should sodium levels be altered? Why?

A

SLOW —> can cause cerebral edema with rapid decrease or osmotic demyelination with rapid increase

< 0.5 mEq/L/hr or 8-12 mEq/day

34
Q

What are the most common causes of hypernatremia? How is it treated?

A
  • prolonged fluid administration
  • water deprivation

0.45% NaCl + 5% dextrose

35
Q

What are the most common causes of hyponatremia? How is it treated?

A
  • profound colitis
  • sepsis

polyionic fluid with 3% NaCl

36
Q

What are the 4 most common causes of hypochloremia? How is it treated?

A
  1. GI loss or sequestration
  2. metabolic acidosis
  3. hyperkalemia
  4. hyponatremia

0.9% NaCl

37
Q

What are 4 indications for administering dextrose? What treatment plan is used?

A
  1. early lactation ketosis
  2. nutritional support in foals
  3. uroperitoneum in foals
  4. urolithiasis in farm animals
    (not commonly an issue in adults)

2.5-10% solution in CRI

  • 100 mL 50% dextrose/1 L = 5% solution
38
Q

You need to make a 2.5% dextrose solution in a 5 L bag using 50% dextrose as the stock solution. How much 50% dextrose do you add to the bag?

A
39
Q

What are the 3 major indications for enteral fluid therapy?

A
  1. functional GIT
  2. maintenance requirements needed
  3. impaction colic
40
Q

What are 4 advantages of enteral fluid therapy?

A
  1. fluid directly into GIT
  2. stimulates colonic motility
  3. decreased expense
  4. decreased need for precise adjustment
41
Q

What equipment is used for enteral fluid therapy? When are indwelling feeding tubes set up?

A
  • nasogastric intubation (2-6 L/dose)
  • funnel
  • electrolyte powder, isotonic electrolyte solution
  • coil set
  • carboy

providing constant administration of fluid 2-5 L/hr

Large Animal Surgery (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions