fluid therapy

Question 1

general principles of fluid therapy

Answer 1

1. Maintenance Fluids- replacement for normal losses via
   urine, feces, respiratory tract and skin.
2. Current deficit to replace dehydration-is an estimate.
3. Continuing losses-occurring
   over a 24 hour period in addition to maintenance requirement

Question 1

function of body fluids

Answer 1

preventing dehydration, hypovolemia, and hypotension and further extreme effects

Question 2

general principles of fluid therapy during anesthesia

Answer 2

2.5 – 5 ml/kg/ hr cats
5 – 10 ml/kg/hr dogs

Question 3

Indicate the factors used in patient assessment prior to fluid therapy

Answer 3

skin tent, eyes, mouth

Question 4

isotonic

Answer 4

balanced electrolyte solutions; shock dose fluids

Question 5

hypotonic

Answer 5

lower concentration of dissolved solutes than blood

Question 6

hypertonic

Answer 6

higher concentration of solute; given with isotonic

Question 7

isotonic osmolality

Answer 7

the liquid has the same osmotic pressure as human blood

Question 8

examples of isotonic solutions

Answer 8

LRS, Plasmalyte, Normosol R

Question 9

When given a fluid, indicate whether it is isotonic, hypotonic or hypertonic

Answer 9

0.9% normal saline does not have K or Ca

Question 10

fluid therapy rate used during anesthesia at Parkland College

Answer 10

5 - dogs
2.5 - cats

Question 11

2 fluid administration systems

Answer 11

drip sets
IV pumps

Question 12

importance of IV administration considerations

Answer 12

• IV bages labeled
• frequent monitoring
• new bag and line for each patient
• flush catheter every 6-8 hours
• aseptic technique
• slowly
• warm fluids

Question 13

clinical signs seen when fluid therapy is under-administrated and over-administrated

Answer 13

Increased respiratory rate and effort (>20% increase)
Watery nasal discharge
Chemosis (eyelid swelling)
Pitting Edema
Restlessness
Coughing

Question 14

course of treatment used for hypotension during anesthesia

Answer 14

1. 1st assess anesthetic depth
2. If too deep – decrease anesthetic depth; Give IV bolus of crystalloid at 3 – 10 ml/kg
3. Repeat once if needed
4. If slow to respond, consider IV colloid
5. If not response, consider medication

Question 15

effects of dehydration

Answer 15

can lose nearly all its glycogen
and fat, half its protein and 2/5 of its body weight; metabolic disturbances and shock

Question 16

calculation for maintenance fluid replacement

Answer 16

40-60 mL/kg/day
40- large
60- small

Question 17

physical indicators of dehydration seen on a physical exam

Answer 17

Acute weight change, skin elasticity, dry mucous
membranes, sunken eyeballs, delayed CRT (>2 secs)

Question 18

clinical evaluation of fluid loss

Answer 18

 PCV-increased (unless blood loss)
 TP-increased (unless blood loss)
 BUN-elevated to 20 or more.
 Creatinine - no change with dehydration
 Urine SG - should be above 1.020 if dehydrated; isosthenuria in the face of dehydration suggests renal failure.
 Hypokalemia - secondary to vomiting/ diarrhea. Can add KCl
to fluids if needed.

Question 19

different types of fluids and fluid additives used

Answer 19

dextrose
potassium
sodium bicarbonate

Question 20

5 common routes of fluids and discuss the advantages and disadvantages of each route

Answer 20

IV- shock, emergency, dehydration, hypovolemia, hypotension, electrolyte imbalance, fast absorption; can be given too quickly
IO- if IV isn’t possible, younger patients, rapid dispersion; short term, infection at site, osteomyelitis
IP- neonates, IV not available; slow absorption, peritonitis, intra-abdominal abscess
SQ- large volumes, cost effective; slow absorption, can’t be used for hypovolemic, hypotensive, severely dehydrated patients
PO- large animal, cost effective, tonicity doesn’t matter; not used for shock

Question 21

IV flow rate for shock

Answer 21

Dogs – start bolus at 20 ml/kg over 15 minutes
Cats – start bolus at 10 ml/kg over 15 minutes