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Nursing > Lecture 4 > Flashcards

Lecture 4 Flashcards

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0
Q

What to mean conditions is fluid therapy used for

A

Hypovolemic shock and dehydration

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1
Q

What is perfusion

A

The process in which blood carries oxygen and important nutrients to body tissues. Depends on many body compensatory responses but also on the administration of appropriate fluid volumes to maintain intravascular volume

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2
Q

What are six purposes of fluid therapy

A

Replace water loss, maintain normal hydration, restore electrolytes and nutrients, vehicle to administer IV medications, replenish blood loss, increase or maintain intravascular osmotic pressure

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3
Q

What percent of an animal’s total body weight is made up of water

A

60%

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4
Q

What percent of body weight is made up of water in neonate’s

A

80%

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5
Q

What are the three main components of total body water distribution

A

Intracellular fluid space. Interstitial fluid space. Intravascular fluid space.

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6
Q

What percent of total body water does intracellular fluid space make up

A

66%

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7
Q

What percent of total body water is interstitial fluid space make up

A

24%

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8
Q

What percent of total body water does intravascular fluid space make up

A

10%

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9
Q

What is considered extracellular fluid

A

Interstitial fluid space and intravascular fluid space

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10
Q

How much percent of total body water does extracellular fluid make up

A

34%

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11
Q

Describe intracellular fluid

A

Within cells

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12
Q

Describe interstitial fluid

A

Between cells

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13
Q

Describe intravascular fluid

A

Water within blood vessels and lymphatic system

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14
Q

What percent of body weight does the blood volume makeup in dogs

A

8 to 9% of body weight

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15
Q

What percent of body weight does blood volume make up in cats

A

6 to 7%.

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16
Q

What is the total body water in a healthy dog

A

534 to 660 mL per kilogram

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17
Q

What is the estimated intravascular water volume in dogs

A

90 mL per kilogram

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18
Q

What is the estimated intravascular water volume in cat

A

45 mL per kilogram

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19
Q

What separates extracellular and intracellular fluid

A

Cell membrane which is permeable to water but not to most solutes

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20
Q

What solutes does body water contain

A

Cations, anions and other solutes

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21
Q

What is responsible for generating concentration gradient across the membrane

A

The ion channels and the active solute pumps

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22
Q

What are the three normal inputs of H2O for an animal

A

Water, food, metabolism of carbohydrates and fat

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23
Q

What are the three things responsible for the loss of H2O in an animal

A

Peeing, pooping, sweating and hypersalivation

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24
Q

What is the estimated water loss over 24 hours from peeing

A

20ml/kg/24hr

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25
Q

What is the estimated water loss over 24hrs from pooping

A

10-20ml/kg/24hr

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26
Q

What is the estimated water loss over 24hrs from sweating and hyper salivating

A

20ml/kg/24hr

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27
Q

What is the total estimated loss per day on average

A

50-60ml/kg/24hr

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28
Q

What is the total estimated fluid loss for puppies/kittens in a day

A

80ml/kg/24hr

29
Q

How do you calculate maintence

A

50-60ml/kg/day

30
Q

What is osmotic pressure

A

The amount of pressure necessary to stop the flow of H2O across a semi permeable membrane

31
Q

What is hydrostatic pressure.

A

It’s basically blood pressure. Pressure generated by the force of a fluid within a compartment

32
Q

What is the colloid oncotic pressure

A

The power of intravascular protein to retain fluid within blood vessels. Opposite to hydrostatic pressure and pulls the fluid into the circulatory system

33
Q

What is the capillary membrane composed of

A

Thin membrane of endothelial cells that contain tight or gap junctions through which fluid and Solutes can flow. Permeable to water and electrolytes but not to proteins

34
Q

What are the two ways solutes dissolved in fluid can flow between compartments

A

By passive diffusion from an area of higher to lower concentration. Or From one compartment to another by active transport mechanism

35
Q

What does the rate of fluid exchange depend on

A

The forces that favor fluid retention within compartments versus the forces that favor fluid movement or filtration from a compartment to another

36
Q

How is the colloid oncotic pressure dictated

A

By the concentration of proteins within the space. Albumin mainly contributes to it. Proteins are large molecules so they remain within blood vessels, retaining fluid with them and thereby maintaining blood volume.

37
Q

What happens when hydrostatic forces exceed oncotic colloid forces

A

Fluid will leave one compartment and go to the other

38
Q

What determines how fluids are distributed during fluid therapy

A

The composition of the administered fluid, in conjunction with the hydrostatic pressure and the colloid oncotic pressure in the capillories and tissues

39
Q

What does the movement of a particular fluid between compartments depend on

A

The permeability of the relevant barrier (capillary membrane versus cell membrane)
The concentration of molecules contained within each compartment

40
Q

What will happen to intravenous fluid containing small molecules

A

It will pass freely out of the capillaries and into the intracellular space. They will be distributed throughout both the intravascular space on the interstitial space

41
Q

What happens to intervenous solutions containing large molecules

A

They will remain within the capillaries. They will expand the intravascular space more efficiently

42
Q

What will happen to intervous solution that is more concentrated than plasma

A

It will draw water into the blood vessels from the intracellular and interstitial spaces

43
Q

What two factors cause a disordered fluid balance

A

Decreased intake or increased output

44
Q

How is the degree of dehydration estimated

A

History, physical exam, laboratory tests

45
Q

When taking the animals history and checking for dehydration what questions do you need to ask about

A

Route of loss, duration of loss, type of loss, frequency and volume of loss, concurrent medical problems

46
Q

When doing the physical examination of the animal how do you estimate dehydration

A

Bodyweight, skin elasticity, pulse quality, mucous membrane color, temperature, attitude, heart rate and respiratory rate

47
Q

What are acute losses of bodyweight considered

A

Mostly fluid losses

48
Q

What does .1 kg of weight lost equal in fluid lost

A

100 mL of fluid

49
Q

What an animal is less than 5% dehydrated what are the physical examination findings

A

History of fluid loss but no physical examination abnormalities

50
Q

What an animal is 5% dehydrated what are the physical examination findings

A

Slight decreased skin turgor, semi dry oral mucous membranes

51
Q

When in animal is 7% dehydrated what are the physical exam findings

A

Mild to moderate decreased skin turgor, dry oral mucous membranes, slight tachycardia, capillary refill time greater than or equal to three seconds

52
Q

What an animal’s 10% dehydrated what are the physical exam findings

A

Moderate to marked decreased skin turgor, Dry oral mucous membranes, moderate signs of shock Pale mucous membranes, tachycardia, capillary refill time greater than three seconds, decreased pulse

53
Q

What an animal is 13% dehydrated what are the physical exam findings

A

Plus or minus marked loss of skin turgor, obvious signs of shock.

54
Q

How do you perform a skin turgor test

A

Twist the skin in between shoulder blades, the time it takes reflects the dehydration of the animal

55
Q

What are some points to keep in mind when estimating the degree of dehydration

A

Aged animals lose their skin elasticity, patients with third space losses have no change in bodyweight: aka pleural effusion or ascites, obese patients or neonates can have abnormally resilient skin even when dehydrated, nausea and salivation moistens dry mucous membranes

56
Q

What are the laboratory tests to test for dehydration

A

Packed cell volume, total protein, BUN, glucose, urine specific gravity, electrolytes, CBC, biochem

57
Q

What are the three phases of fluid therapy

A

Emergency phase (hypovolemic shock) replacement phase (dehydration), maintenance phase (maintenance volume)

58
Q

Describe shock

A

Ineffective perfusion of tissues with blood. Results in cellular hypoxia

59
Q

What are the six signs of shock

A

Pale mucous membranes, increased capillary refill time, tachycardia, weak pulse, depression, cool extremities

60
Q

What is hypovolemia

A

Decreased fluid volume within the intravenous space due to hemorrhage or trauma.

61
Q

What happens when more than 25% of intravenous volume is lost

A

Severe hypovolemia and hypotension. This leads to hypovolemic shock

62
Q

What happens when 50 to 60% of intravenous volume is lost

A

Cardiac arrest

63
Q

What are some common causes of hypovolemia

A

Significant hemorrhage, loss of plasma water during severe vomiting or diarrhea, end-stage dehydration, inadequate intake, hypoproteinemia

64
Q

What is the goal of the emergency phase

A

To reverse hypotension and shock, not to correct dehydration

65
Q

What happens if the clinical signs of shock resolve after the first bolus of fluid

A

Proceed to replacement face if the animal is dehydration or the maintenance phase if he is not dehydrated but not eating or drinking

66
Q

How do you tell if the clinical signs of hypovolemia are resolved

A

Mucous membrane color improves, heart rate decreases, pulse quality improves, attitude of animal improves, capillary refill time improves, respiratory rate stabilizes, peripheral extremities are warm

67
Q

What volume of fluid is needed for dogs in the emergency phase

A

60 to 90 mL/kg/hr

68
Q

What amount of fluid is needed for a cat in the emergency phase

A

45 to 60 mL/kg/hr

69
Q

How do you calculate how many milliliters of fluid you need for the replacement phase

A

Deficit volume (hydration deficit), maintenance volume, abnormal ongoing losses volume

70
Q

What is the deficit volume or the hydration deficit

A

Amount of fluid to be replaced to bring audible back to normal hydration status

71
Q

What is maintenance fluid

A

The volume of fluid and amount of electrolytes that must be taken in on a daily basis to keep the volume of total body water and electrolyte content normal.

Nursing (16 decks)

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