How Much Fluid? (ASAN002/4)

Question 1

To determine how much fluid is required, we need to calcuate how much fluid is needed to: (3)

Answer 1

• Replace (rehydrate) fluid loss
• Maintain normal hydration
• Predict any ongoing losses

Question 2

What do we need to calculate to determine how much fluids we need for Rehydration? (2)

Answer 2

Calculate the amount of missing fluids or Fluid Loss.

Question 3

How do we calculate fluid loss (L)? (1)

Answer 3

Weight kg x % dehydration = L fluid loss

eg: 10kg patient with 5% dehydration
10 x 5/100 = 0.5L = 500mls

Question 4

What is the quick formula to give Fluid Loss in ml? (1)

Answer 4

% dehydration x weight kg x 10 = mls

eg: 10kg patient with 5% dehydration
5 x 10 x 10 = 500mls

Question 5

What do we need to calculate to determine how much fluids we need for Maintenance? (2)

Answer 5

Insensible fluid losses (GIT, Resp, Skin)
+
Sensible fluid losses (urine, faeces)

Question 6

What are Insensible Losses? (3)

Answer 6

Fluids lost through:
* Gastrointestinal Tract
* Respiratory Tract
* Skin / Sweating

Question 7

What is the calculation for Insensible losses? (1)

Answer 7

20mls/kg/day

Question 8

What are Sensible Losses?

Answer 8

Fluids lost through:
* Urine
* Faeces

Question 9

What is the calcuation for Sensible losses? (2)

Answer 9

1–2ml/kg/hour = 24–48mls/kg/day

Question 10

What is the calculation to estimate Combined Maintenance Volume? (1)

Answer 10

40 – 60ml/kg/day

Question 11

Why do large dogs typically have lower maintenance volume requirements than small dogs? (1)

Answer 11

Due to lower surface area : body mass ratio

Question 12

What does Ongoing Fluid Losses refer to? (1)

Answer 12

Fluid loss > maintenance req of normal patient

Question 13

What are some examples of Ongoing Fluid Losses? (4)

Answer 13

• Vomiting
• Diarrhoea
• Bleeding
• Wound exudate

Question 14

How do we calculate Ongoing Fluid Losses? (1)

Answer 14

Need to estimate as difficult to predict & calculate exact amt.

Question 15

How do we Calculate Fluid Requirements? (4)

Answer 15

Fluid Requirement

fluid deficit
+ maintenance requirements
+ ongoing losses

Question 16

What fluid rates do Fluid pumps use? (1)

Answer 16

hourly fluid rates

Question 17

What fluid rates do Gravity fed adminstration systems use? (1)

Answer 17

Rates calculated at drops per second.

Question 18

What is the drop rate for most common admin sets? (1)

Answer 18

20 drops/ml

Question 19

Example 1:
10kg dog, 8% dehydrated. Has diarrhoea & estimated further loss of 140mls over 24hrs
(Image)

Answer 19

Question 20

Example 2:
20kg dog, 10% dehydrated. Has V & D, and estimated further loss of 360mls over 24hrs
(Image)

Answer 20

Question 21

What are the two types of Fluid Delivery Systems? (2)

Answer 21

• Gravity fed systems
• Mechanical delivery systems (pumps)

Question 22

How do Gravity Fed Systems work? (1)

Answer 22

Rely on gravity to create flow of fluids.

Question 23

How do you calculate & adjust fluid rates on Gravity Fed Systems?

Answer 23

• Roller pinches line to regulate flow.
• Drip chamber to calculate flow/drip rate (must know drops/ml of admin set)

Question 24

What are the different drop/ml admin sets most commonly available? (4)

Answer 24

Available in 10, 15, 20 or 60 drop/ml

Question 25

What are the limitations of Gravity Fed Systems? (3)

Answer 25

* Infusion pressure dependent on how high fluids are above the patient. * Flow limited by ambulatory patient & catheter placement * Patient limb must be fully extended when changing flow rate.

Question 26

What is a Burette or Buretrol? (1)

Answer 26

A measuring chamber that can added to gravity fed systems.

Question 27

What are the benefit of using a Burette or Buretrol? (3)

Answer 27

* Accurate delivery of small volumes (holds 100 – 150mls) * Reduces risk of fluid overload in small patients

Question 28

How do Mechanical Delivery Systems work?

Answer 28

They use a mechanical pumping system to deliver fluids

Question 29

What are the two main types of Mechanical Delivery systems? (2)

Answer 29

* Syringe pumps * Fluid infusion pumps (NIKI pump)

Question 30

What are syringe pumps best used for? (2)

Answer 30

* Administering IV medications at a constant rate. * Administering fluids to small patients.

Question 31

How do Syringe Pumps work? (3)

Answer 31

* A syringe is filled with appropriate fluid or medication. * Syringe is placed in the pump. * The plunger is automatically pushed at a constant rate.

Question 32

How do Fluid Infusion Pumps (NIKI pumps) work? (1)

Answer 32

They use peristaltic action (intermittent squeezing of IV tubing) to pump fluid into the patient.

Question 33

What is a possible complication of Fluid Infusion Pumps? (2)

Answer 33

* They can infuse fluids at a high pressure * Therefore, may pump fluid into perivascular tissues

Question 34

What information should be included when Labeling Fluid Bags?

Answer 34

* Date & time of when bag was hung. * Initials of who hung the bag. * Concentration of additives in the bag.

Question 35

Why is placing Labels on fluid bags important? (4)

Answer 35

Shows all staff: * The contents of the bag * When the bag was hung * Staff member that hung the bag

Question 36

What is an additional way to label gravity fed fluid bags? (1)

Answer 36

Place tape on bag to monitor how much fluid is given over time.