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anesthesiology > Fluid Therapy (L 19-20) > Flashcards

Fluid Therapy (L 19-20) Flashcards

1
Q

What is the body fluid distribution?

A

ICF 2/3

ECF 1/3

  • Interstitial 3/4
  • Plasma 1/4
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2
Q

What percent of body weight is on average intravascular blood volume?

A

Dogs 10%

Cats 8%

Horse 7%

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3
Q

Where is Na+ primarily distributed in the body?

A

ECF

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4
Q

Where is K+ primarly distributed in the body?

A

ICF

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5
Q

Where is Cl- primarly distributed in the body?

A

ECF

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6
Q

Where is HCO3_ primarily distributed in the body?

A

ECF

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7
Q

Define Osmosis

A

Movement of water through semipermeable membranes

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8
Q

Define Osmotic pressure

A

Pressure on one side of the membrane that prevents movement of water

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9
Q

Define Osmolarity

A

particles/L solution

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10
Q

Define Osmolality

A

Particles/kg H2O

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11
Q

Define Oncotic pressure

A

created by large molecules–>pulls water towards it

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12
Q

What is serum osmolality?

A

300mOsm/kg

(270-350)

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13
Q

Define hydration

A

State of extracellular volume (interstitial & intravascular space)

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14
Q

Define Volemia

A

Only intravascular volume

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15
Q

How do you assess hydration status?

A

Skin elasticity (turgor)

Body weight

MM moisture

Urinary production/USG (oliguria, high USG)

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16
Q

What types of fluids are crystalloids?

A

Isotonic, hypotonic or hypertonic

Cheap

But only 1/4-1/3 of volume infused is still present in vasculature after 1hr. Can cause edema with large infusions.

17
Q

What Cx with variying levels of dehydration?

A
  • <5% - not detectable
  • 5% - dry MM, normal skin turgor
  • 6-7% - dry MM, mildly decreased skin turgor
  • 10% - eyes sunken, highly decreased skin turgor, increased CRT
  • 12-15% - signs of shock, death imminent
18
Q

What fluids should not be used in shock fluid thereapy?

A

Fluids with Low or no sodium.

Ex: Dextrose in water and hypotonic saline solutions

19
Q

What are the clinical uses of hypotonic crystalloids?

A

Replace water deficits/losses

Drug admixtures

20
Q

What can misuse of hypotonic crystalloids do?

A

Large doses rapitdly can cause water intoxication (sellular edema)

21
Q

What are the advantages of isotonic crystalloids?

A
  • Commonly available/economical
  • Replace interstitial deficits
  • Restores effective circulating volume
  • Good replacement solutions for D+/V+ & diuresis loss
  • Polyionic crystalloids do not alter normal electrolyte values
22
Q

What are the disadvantages of crystalloids?

A
  • Rapidly redistributed to interstitial fluid compartment
    • only 20% remains intravascular (need large volumes)
  • Interstitial Edema
    • Cerebral
    • Pulmonary
    • Systemic
  • Hemodilution
    • RBC’s, Albumin & Coagulation factors (bleeding)
  • Rebleeding
23
Q

If you use LRS for long term fluid therapy what do you need to add to the bag?

A

K+ (only get from diet)

24
Q

What is the Na+, Cl-, K+ & HCO3 levels in LRS?

A
  • Na+ = 130
  • Cl- = 109
  • K+ = 4
  • “HCO3” = 28 lactate (turned to HCO3 by liver)
25
Q

What is the Na+, Cl-, K+ and HCO3 levels in
Plasmalyte 148 & Normosol R?

A
  • Na+ = 140
  • Cl- = 98
  • K+ = 5
  • “HCO3” = 27-acetate & 23 Galactate (HCO3 precursers)
26
Q

What is the Na+, Cl- K+, and HCO3 in

0.9% NaCl (saline)?

A
  • Na+ = 155
  • Cl- = 155
  • K+ = 0
  • HCO3 = 0
27
Q

What is the Na+, Cl- K+, and HCO3

in Ringers solution?

A
  • Na+ = 148
  • Cl- = 156
  • K+ = 4
  • HCO3- = 0
28
Q

Signs of Hypo & Hyper KALEMIA (K+)?

A
  • Hypokalemia
    • mm. weakness
    • decreased myocardial contractility
  • Hyperkalemia
    • bradycardia
    • cardiac arrest
29
Q

When an animal is dehydrated,

how does the fluid move?

A

ICF → ECF

30
Q

K+ maintains the ______ ______ potenial

A

resting membrane

31
Q

What are the C/S of 5% dehydration?

A
  • Dry MM
  • Normal skin tugor

anesthesiology (15 decks)

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