Fluid Therapy & Shock p1 Flashcards
Water functions (3)
- Most body chemical reactions
- Transport of solutes/gases
- Temperature regulation
- Electrolyte balance
Intracellular fluid (ICF) is…
Fluids within the cell
- 2/3 of body water
Extracellular fluid (ECF) is…
Fluid within the blood vessels (intravascular) and in the tissue spaces between the blood vessels and cells (interstitial).
- 1/3 of body fluid
Define in regard to the concentration of salts & solutes dissolved in blood:
1. Plasma osmolality
2. Sodium control
3. Thirst
- Regulated by water balance in the body.
- By adrenal glands and kidneys is another major control mechanism to thirst.
- The primary controlling mechanism
Water balance methods:
1. Intake (4)
2. Loss (6)
- Intake
- Ingested water
- In food
- From nutrient metabolism
- Iatrogenic (ie IV or SQ fluids) - Loss
- Urine
- Stool
- Vomiting
- Respiration
- Sweat
- Iatrogenic (ir Abdominocentesis)
Effective circulating volume is…
Fluid in vascular compartment that is effectively perfusing tissues
Circulating volume controlled by:
1. Vascular tone
2. Blood sodium level
- Vascular
- Controlled by sympathetic nervous system & adrenal gland.
- Measured by blood pressure - Blood sodium
- Controlled by kidneys
- Measured by blood evaluation & urine concentration.
Describe each percent of dehydration:
a. <5%
b. 5%
c. 7%
d. 10%
e. 12%
a. History of fluid loss but no findings on physical exam.
b. Dry oral MM but no panting or pathological tachycardia.
c. Mold to moderate decreased skin turgor, dry oral MM, tachycardia, & decreased pulse pressure.
e. Marked loss of skin turgor, dry oral MM, and significant signs of shock.
What is shock?
Circulatory shock is a life-threatening state of poor perfusion
Dynamics of shock:
Compensatory phase
Decompensatory shock is characterized by: (4)
- Hypotension
- Tachycardia
- Prolonged CRT
- Hypothermia
What are effects of shock? (7)
Poor perfusion which leads to cell death
1. Heart arrhythmias
2. Kidney failure
3. Brain failure
4. Immunosuppression
5. Bleeding disorders
6. Intestinal slough
7. Death
Types of shock (4)
- Hypovolemic
- Obstructive
- Distributive
- Cardiogenic
Describe each kind of shock:
1. Hypovolemic
2. Obstructive
3. Distributive
4. Cardiogenic
- Insufficient vascular volume
- Most common - Physical obstruction of circulation
- Body fluids in inappropriate location
- Failure of heart function
What is the purpose of fluid therapy? (5)
- Restore water balance
- Restore electrolyte balance
- Remove toxins
- Treat or prevent organ failure
- Treat or prevent hypotension or shock
Name the advantages (2) and disadvantages (3) for both routes of fluid administration:
1. Oral
2. Subcutaneous
Name the advantages and disadvantages for both routes of fluid administration:
1. Intraosseous (3, 2)
2. Rectally (2, 1)
Phases of fluid therapy:
1. Emergency phase (3)
2. Replacement phase (2)
3. Maintenance phase (2)
- Tx of shock
- Tx of acute renal or liver failure
- Dehydration & shock - Replace deficit estimated from clinical status and blood/urine results.
- Treats dehydration - Administer fluid & electrolytes and the rate at which they are lost due to urine, feces, vomiting, etc.
- Prevents dehydration
What is a technician’s role in fluid therapy? (3)
- Ensure that the fluid type and route prescribed is delivered safely & effectively.
- Monitor and record fluid losses
- Urine & feces
- Vomiting
- Centesis - Evaluate patient parameters for under- or over-hydration & notify DVM.
Signs of overhydration (5)
- Tachypnea
- Crackles or “wet” lung sounds
- Edema
- Feet
- Conjunctiva
- Gravity dependent body - Weight gain
- Ascites or pleural effusion
What are things to monitor during fluid therapy? (6)
- Accurately weigh patient daily.
- BID for small Pt (>15lbs) - Eval hydration status daily
- Record urine output (quantitative)
- Record HR and RR at least TID
- Auscult lungs at least TID
- Notify DVM of trends in above parameters
