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Vet Nursing > IV Catheterization and Fluids > Flashcards

IV Catheterization and Fluids Flashcards

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1
Q

What are the laboratory indicators of dehydration?

A

PCV, Total Plasma Protein, Urine specific gravity

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2
Q

Why is the medial saphenous avoided for catheterization/IV in cats?

A

Difficult area, creates kinks

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3
Q

In a non-critical situation what can be administered to make catheterization easier?

A

SQ fluids

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4
Q

Where are central venous catheters placed?

A

Jugular vein or caudal vena cava (via femoral vein)

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5
Q

Catheter rate of flow depends on what?

A

Blood pressure, resistance in administration system, pressure or height of fluid source

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6
Q

What technique is required for IV catheterization?

A

Aseptic technique

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7
Q

What is used to flush out the catheter? (This must be done periodically during catheterization)

A

Heparinized saline or sterile saline

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8
Q

Why does the catheter have to be flushed?

A

To prevent clots

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9
Q

What are three types of catheters?

A

Winged Infusion set (Butterfly)

Over the Needle Catheter

Through the Needle Catheter

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10
Q

What are butterfly catheters used for?

A

Short procedures such as drug administration

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11
Q

What is the advantage of butterfly catheters?

A

Easy to place

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12
Q

What are the disadvantages of butterfly catheters?

A

Can easy lacerate the vein

Frequently slides out

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13
Q

What are some advantages of the Over-the-Needle Catheters?

A

Easy to place

Causes minimal discomfort

Permits maximum flow rate

Can be maintained up to 3 days

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14
Q

What are some disadvantages of Over-The-Needle catheters?

A

Tip can fray/burr

Hard to get through tough skin

Can be easily removed by patients

Can slide out

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15
Q

Through-The-Needle catheters are also known as what?

A

Intrafuser/Venocath/Intracath

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16
Q

When are Through-the-Needle catheters used?

A

Critical care situations

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17
Q

Large bore needle through which a catheter is threaded into a vessel.

A

Through the Needle Catheter

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18
Q

What are the advantages to TTN catheters?

A

Catheter can be maintained up to 5 days

Allows high volume fluid administration

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19
Q

What are the disadvantages to TTN catheters?

A

Very expensive

Difficult to place

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20
Q

What is the most common catheter?

A

Over-the-Needle Catheter

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21
Q

What must a bag of heparinzed saline be labeled with?

A

What was added

How many units added

Date prepared

Initials

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22
Q

Once mixed, how must heparinzed saline be stored?

A

Must be refrigerated

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23
Q

What is used for drip rates >100 ml/hr?

A

Macrodrip

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24
Q

What is used for drip rates <100 ml/hr?

A

Microdrip

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25
Q

What size do Microdrips come in?

A

Only 60 gtt/ml

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26
Q

What are “piggybacks” used for?

A

Administering 2 fluids at the same time

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27
Q

Which bag must be higher when administering piggybacks?

A

Secondary bag must be hung higher than primary

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28
Q

Piggybacks are most often used to administer what?

A

Antibiotics

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29
Q

What is used to control administering small amounts of fluid?

A

Volume Control Chambers

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30
Q

What is the IV fluid administration rate for a dog in shock?

A

40 ml/lb/hr (88 ml/kg/hr)

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31
Q

What is the IV fluid administration for a cat in shock?

A

25 ml/lb/hr (55 ml/kg/hr)

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32
Q

What is the IV fluid administration rate for surgery?

A

5 ml/lb/hr (11 ml/kg/hr)

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33
Q

What is the IV fluid administration rate for maintenance?

A

30 ml/lb/day (66 ml/kg/day)

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34
Q

Total amount of IV fluid administration is calculated by the sum of what three things?

A

Amount needed to correct dehydration

Daily maintenance needs

Amount needed to replace fluid loss (from v/d)

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35
Q

What are some medical conditions that cause fluid imbalance?

A

Loss of protein

Endocrine disease

Organ Failure

Cancer

Trauma

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36
Q

60% of the body (by weight) is known as what?

A

Total Body Water (TBW)

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37
Q

2/3 of the TWB is located…

A

within the cells (intercellular fluid)

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38
Q

1/3 of the TBW is located…

A

outside the cells (extracellular fluid)

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39
Q

What is the daily water gain?

A

20-30 cc/lb/day (40-60 cc/kg/day)

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40
Q

What is the daily water loss?

A

20-20 cc/lb/day (1-2 ml/kg/day)

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41
Q

Daily water loss is increased in…

A

Neonates

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42
Q

Sensible water loss

A

10-20 cc/lb/day

Urine

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43
Q

Insensible water loss

A

10 cc/lb/day

Fecal water

Sweat/Respiration

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44
Q

What are the major electrocytes of extracellular fluids?

A

Sodium, Chloride, Bicarbonate

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45
Q

What are the major electrolytes of intracellular fluid?

A

Potassium, magnesium, phosphorus

46
Q

What is the most abundant electrolyte?

A

Sodium

47
Q

What primarily influences water distribution?

A

Sodium

48
Q

What is a clinical sign of sodium imbalances?

A

Primarily neurological problems

49
Q

What is hyponatremia?

A

Low Sodium Levels

50
Q

What is hypernatremia?

A

High Sodium Levels

51
Q

What is the dominant intracellular ion?

A

Potassium

52
Q

What does potassium provide for the body?

A

It maintains osmotic pressure and cell metabolism and is responsible for the electical potentials in the muscles and nerves

53
Q

What are some symptoms of hypokalemia?

A

Muscle weakness, polyuria, polydipsia

54
Q

What are the clinical signs of hyperkalemia?

A

ECG changes

Bradycardia

55
Q

In what conditions is hyperkalemia seen?

A

Urethra obstruction

Aniuria/Oliguria

Addison’s disease

Renal failure

56
Q

What is the normal blood pH?

A

7.35-7.45

57
Q

What are the most important regulators of pH?

A

Kidneys, lungs, buffers

58
Q

What laboratory tests are used to determine fluid therapy needs?

A

Chemical profiles

PCV/TP

Urine specific gravity

59
Q

Choice of fluids is based on what?

A

Severity of dehydration

Composition of fluids lost

Abnormality requiring correction

60
Q

Crystalloid Fluids

What are they, what do they do?

A

Contain small solute particles which can pass through membranes

These fluids move into all body compartments

61
Q

Colloid fluids

What are they, what do they do?

A

Contain large solute particles that do not pass through membrane

These fluids remain in the intravascular compartment

62
Q

Balanced Fluids

What are they similar to, and what are some examples?

A

Are very close to extracellular fluids in solute content

Ex. Lactated Ringers- contain Na, Cl, K, and Ca

63
Q

Unbalanced fluids

What are they, what are some examples?

A

Unlike extracellular fluids in terms of solute content

Ex. 0.9% saline, contains only Na and Cl

64
Q

Replacement fluids contain solutes that closely resemble…

A

Plasma

65
Q

Replacement fluid content

A

High sodium and chloride

Lower amounts of potassium and other solutes

66
Q

Maintenance fluids contain solutes that closely resemble…

A

Total Body Water

67
Q

Maintenance fluids content

A

Lower sodium and chloride

Higher potassium

68
Q

Hemorrhage can result in what?

A

Hypovolemia (low blood volume)

Cardiovascular collapse

69
Q

What must be done to prevent further blood loss from hemorrhaging with fluid therapy?

A

Aggressive, fast replacement of vascular volume

70
Q

What is the medical definition of shock?

A

Condition in which blood pressure is inadquate to deliver oxygen and nutrients to vital organs and tissues

71
Q

What is the treatment for shock?

A

Identifiying cause

Restoring blood volume

Improving tissue perfusion

72
Q

What are the characteristics of Crystalloid fluid solutions?

A

May be balanced or unbalanced

Hypo, Hyper, or Isotonic

May be designed for replacement and/or maintenance

*Most commonly used*

73
Q

Examples of isotonic solutions

A

0.9% NaCl

Lactated Ringers

Normosol-R

Dextrose 5% in water

2.5% Dextrose in 0.45% Saline with KCl added

74
Q

Examples of Hypertonic solutions

A

3,4,5, or 7% Saline

50% Dextrose

LR with 5% Dextrose

75
Q

Example of Hypertonic solutions

A

Normosol-M

76
Q

0.9% Saline (normal saline) should not be used in patients suffering heart disease for what reason?

A

High sodium content can cause heart to stop

77
Q

Lactated Ringers can not be used in patients receiving blood transfusions. Why?

A

Due to calcium content- can cause clots

78
Q

What fluids are given as replacement?

A

Lactated Ringers

Normosol-R

79
Q

What fluids are given as maintenance?

A

Normosol-M

2.5% Dextose in 0.45% Saline with KCl

80
Q

When are colloid treatments indicated?

A

Treatment of shock

Treatment of Hypoproteinemia

81
Q

What are natural colloids?

A

Whole blood

Blood plasma

82
Q

What are the synthetic colloids?

A

Dextran 40

Dextran 70

Hetastarch

Oxyglobin

83
Q

What is the additive sodium bicarbonate used to treat?

A

Acidosis

84
Q

When administering sodium bicarbonate it is important to administer it how?

A

VERY slowly, administering too quickly can kill the patient!

85
Q

What is the additive potassium chloride used to treat?

A

Hypokalemia

86
Q

What are the toxicity signs when administering KCl?

A

Muscle weakness, arrythmias

87
Q

What is 50% Dextrose used to treat?

A

Hypoglycemia in neonatal food animals, foals, and small animals

Ketosis in cattle and pregnancy toxemia in sheep

88
Q

For patients with severe fluid deficits in need of rapid fluid and electrolyte delivery, what route should NOT be used?

A

Oral

89
Q

In what situations is oral fluid therapy indicated?

A

If the GI tract is functioning properly

Maintenance needs

May supplement with commericially available human electrolyte products

90
Q

What is the route of choice when small volumes of fluid therapy are needed?

A

Subcutaneous

91
Q

When are SQ fluids contraindicated?

A

If animals require large replacement volumes, hypothermic patients, or severely dehydrated

92
Q

Where are SQ fluids administered?

A

Where loose connective tissue is abundant

SQ space over dorsal neck, and cranial trunk

93
Q

What are the benefits of warming SQ fluids before administration?

A

Encourages absorption and benefits hypothermic patients

94
Q

Dextrose solutions >2.5% should never be given SQ. Why?

A

Causes skin sloughing or abscesses

95
Q

In what cases is intravenous fluid therapy the most preferable route?

A

When treating critically ill, severely dehydrated, hypovolemic or patients experiencing metabolic disorders

96
Q

What route of fluid therapy is the most rapidly effective on blood volume?

A

Intravenous

97
Q

What complications are associated with intravenous fluid therapy?

A

Infection

Phlebitis

Hematoma formation

Thrombosis

98
Q

What bones are used for intraosseous fluid therapy?

A

Femur, humerous, wing of ileum

99
Q

What fluid therapy route is excellent for access to peripheral circulation?

A

Intraosseous (absorption equivalent to intravenous)

100
Q

What route of fluid therapy is commonly used in guinea pigs, rodents, and hamsters?

A

Intraperitoneal

101
Q

Intraperitoneal has the same absorption rate of what other route?

A

SQ

102
Q

What affects rate of fluid administration?

A

Disease

Rate of fluid loss

Clinical signs

Cardiac and renal function

Fluid type and administration

103
Q

Daily fluid requirements =

A

Replacement +

Maintenance +

Ongoing losses

104
Q

Fluid Deficit=

A

% dehydration X body weight (kg) X 10

105
Q

What is the best way to evaluate the fluid status of a patient?

A

Central venous pressure

Monitoring reduces chance of volume overload

106
Q

What measures central venous pressure?

A

Manometer

107
Q

What are the signs to fluid overload?

A

Hyperpnea (panting)

Nasal discharge

Chemosis (swelling of conjunctiva)

Pitting Edema

108
Q

If fluid overload is suspected what should be monitored?

A

Lungs for pulmonary edema

109
Q

How does the veterinarian know how much fluid to give an animal?

A

Volume needed to rehydrate the patient + volume needed for maitenance + volume needed to correct ongoing losses

110
Q

What is the approximate maintenance fluid requirement?

A

66 ml/kg/day

111
Q

When measuring contemporary (on going losses) what is being observed and how should it be measured?

A

Volume lost in diarrhea, or vomitus in ml’s

Double visual estimate

Vet Nursing (5 decks)

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