Fluid therapy

Question 1

If you have a chronic problem can you replace it acutely?

Answer 1

NO; instead causes dilution effect in which all the fluid is lost through the kidneys!

Question 2

How does it take for a balance electrolyte solution to equilibrate with intravascular component (IV)?

Answer 2

1 hr

Question 3

How should you treat hyponatremia & what are you trying to avoid?

Answer 3

correct SLOWLY (no more than 0.5 mEq/hr) to avoid central pontine myelinosis (destruction of myelinated fibers in pons) 
i.	CS include lethargy, weakness, ataxia, hypermetria & tetraparesis

Question 4

How should you treat hypernatremia & what are you trying to avoid?

Answer 4

Correct chronic hypernatremia slowly, if done too quickly get cerebral edema

Question 5

Hypokalemia TX

Answer 5

acute potassium replacement must not be more than 0.25-0.5 mEq/kg/hr –> takes up to 48 hours for potassium to become incorporated into cells.

Question 6

Hyperkalemia- concerning CS

Answer 6

ventricular fibrillation (life threatening)

Question 7

Hyperkalemia TX- mild/mod and severe

Answer 7

Dextrose/insulin for hyperkalemia & bicarb when pt. is academic; with severe dysrhythmia add calcium gluconate

Question 8

What is the fluid of choice for metabolic alkalosis?

Answer 8

normal saline + potassium chloride

Question 9

What is the routine maintenance rate during routine procedure:

Answer 9

5 mL/kg/hr (dog) & 2-3 mL/kg/hr (cat) of balanced crystalloid solution

Question 10

When should you give balanced fluid vs. blood product with blood loss?

Answer 10

use fluid replacement with blood loss less than 20 % (3:1 ratio added to maintenance); when greater than 20% requires blood transfusion

• Ex. animal loses 20 mL blood replace by 60 mL LRS