01 - fluid therapy

Question 1

(body water)

1. total body water is about 50 to 70% of body weight in adults
2. intracellular is what % of bw?
3. extracellular?

interstitial?

intravascular fluid?

Answer 1

2. 40%
3. 20%

12-14%

6-8%

Question 2

(electrolytes)

1. what are high in extracellular fluid and low in intra?
2. vice versa?

Answer 2

1. Na and Cl
2. K, Mg, phosphorus

Question 3

(maintenance requirements)

1. how much is insensible water loss?
2. how much is sensible losses in normal animals consuming food?

Answer 3

1. 20 mL/kg/day
2. 20 to 40 mL/kg/day

Question 4

(type of dehydration)

(isotonic dehydration)

1. normal serum sodium concentration in the presence of dehydration
2. occurs when there is a loss of water and electoryles in proportion to that in serum

Question 5

(detection of dehydration)

Question 6

is metabolic acidosis or alkalosis common in dehydration?

Answer 6

acidosis

Question 7

Question 8

(crystalloid

1. crystalloid solutions redistribute quickly.

best for what?

2. what is the osmolality divider for hypo/hyper

Answer 8

1. rehydration or replacement of fluid loss
2. 300 mOsm/kg

Question 9

(colloid solutions)

1. ideal for what?
2. not good for replacing what?
3. mostly used in patients with what conditions?
4. caution in what animals?

Answer 9

1. replaceing intravascular volume
2. replacing extravascular fluid loss
3. hypoproteinemia, low oncotic pressure, treatment of shock
4. noncardiogenic pulm edema, CHF, renal origin oliguria or anuria

Question 10

(supplementation of parenteral fluids)

(potassium)

1. added to fluids if K below what level?
2. do not exceed a rate of what?

Answer 10

1. 3.5 mEq/L
2. 0.5 mEq/kg/hr

IMPORTANT - can kill!

Question 11

(supplementation of parenteral fluids)

(alkali)

1. add sodium bicarb if alkali replacement is needed quickly
2. don’t add to fluids containing Ca

Question 12

(supplementation of parenteral fluids)

(magnesium)

1. indicated in patient’s with what three conditions?
2. don’t use in oliguric patients

Answer 12

1. hypokalemia, diabetic ketoacidosis, and CHF

Question 13

(supplementation of parenteral fluids)

(dextrose)

1. indicated in hypoglycemia owing to sepsis, insulinoma, overdose of insulin, and liver disease

Question 14

(supplementation of parenteral fluids)

(calcium)

1. use calcium in what form?
2. don’t use subq
3. indicated when?

Answer 14

1. calcium gluconate or calcium chloride
2. hypocalcemic seizures or tetany

(monitor heart rate; bradycardia is a sign of toxicity)

Question 15

(supplementation of parenteral fluids)

(phosphorus)

1. only significant hypophosphatemia requires phosphorus supplementation

Question 16

(routes of administration for parenteral fluids)

Question 17

1. use what guidelines for monitoring efficacy of fluid therapy?

Answer 17

body weight

PCV and plasma proteins

central venous pressure (prevent overloading of heart)

electrolytice and acid-base status