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Flashcards in Fluid therapy Deck (26)
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1
Q

need for fluid therapy

A

Replacement of fluids “lost”

Maintenance of fluid “needs”

2
Q

ways to loose fluid

A
Blood loss 
Dehydration 
excessive urination 
Vomiting, diarrhoea 
Sequestered fluid (“third space”– in bowel, in cavities)
3
Q

“flushing things out”

A

azotaemia (pre-renal, renal, post-renal) may require fluid therapy as a means of increasing Glomerular Filtration Rate (GFR)
Animals intoxicated with water soluble substances may also benefit from fluid therapy

4
Q

whats in a fluid bag

A

Water
Electrolytes - Sodium, Chloride, Potassium, Magnessium, Calcium
± Buffers - Lactate, Citrate
± Dextrose

5
Q

Fluid Therapy to Deliver Nutrients

A

When animals cannot receive nutrition through the gastrointestinal tract (enteral nutrition) animals may be fed parenterally

6
Q

fluid types

A

Crystalloids

Colloids - Natural, Synthetic

7
Q

fluid tonicities

A

Isotonic
Hypertonic
Hypotonic

8
Q

Crystalloids - Components

A

Water + small molecules
Electrolytes - Sodium, Chloride, Potassium, Magnessium, Calcium
± Buffers - Lactate, Citrate
± Dextrose

9
Q

crystalloids

A

Most common used fluid in practice
Cheapest
Can be administered PO, IV, SQ, IO, IP
After administered, distributes equally amongst all fluid compartments - Only a third of volume remains intravascularly after equilibration
Complications only related to amounts of fluid used (too little/too much)

10
Q

Synthetic Colloids - Components

A

water + large molecules
electrolytes - sodium, chloride
+/- buffers - lactate, citrate

11
Q

Synthetic Colloids

A

Some form of colloid available in most practices
Can be rather expensive
Generates colloid osmotic pressure - This delays equilibration of fluid with other compartments, Useful for resuscitation of intravascular volume
Complications include fluid overload and coagulopathy
unavailable in UK
possible harm to patients – kidney injury mainly

12
Q

natural colloids

A

Blood products - Fresh whole blood, Packed red blood cells, Fresh frozen plasma
Concentrated albumin solutions

13
Q

parenteral nutrition

A

Mixture of amino acids solutions, dextrose, lipids (all crystalloids)
Provides energy and building blocks for protein synthesis

14
Q

Effects of Tonicity

A

Isotonic = same tonicity as blood
Hypertonic = much higher than blood
Hypotonic = less than blood
Tonicity determines distribution of fluid between compartments, i.e., tonicity is what can move fluids from one compartment to another

15
Q

Isotonic fluid administered IV - effect

A

fluid distributed equally amongst all compartments

16
Q

Hypertonic fluid administered IV - effect

A

Draws fluid from intracellular and interstitial compartments into intravascular compartmen

17
Q

Hypotonic fluid administered IV - effect

A

Fluid shifts to the intracellular compartment – cellular oedema

18
Q

isotonic crystalloid use

A
Rehydration 
Resuscitation – treatment of hypovolaemia 
Correction of acid/base electrolytes 
Deliver drugs 
Induce diuresis
19
Q

Considerations for colloid use

A
Require rapid resuscitation 
Want to increase COP 
Need resuscitative effect to last more than 1 hr 
Most colloids are isotonic 
Typically used when animal is oedematous
20
Q

hypertonic saline use

A
Not used very much
extremely rapid resuscitation 
Very effective! 
Patient has to be well hydrated for hypertonic saline to work 
Can be used to treat brain oedema 
Very small doses required
21
Q

mannitol

A

Most commonly used for brain oedema
Treatment for acute glaucoma
Sometimes used for oliguric renal failure
Osmotic diuretic – main effect is to shift fluid into the intravascular space to be excreted by the kidneys

22
Q

hypotonic fluid use

A

Not used very much at all
Supposed to be a true “maintenance fluid”
For short term use – only a few hours
Only really useful if you are treating extremely hypernatraemic patients
Nicknamed “Devil’s Fluid” - Causes too many complication with electrolytes and cellular oedema

23
Q

Parenteral Nutrition - Indications

A

Dysfunctional GI tract - vomiting, diarrhoea
Existing malnutrition or risk of becoming malnourished
contraindicated enteral feeding
Pancreatitis (?)
Unable to protect airway

24
Q

Total Parenteral Nutrition

A
Meets 100% of energy requirements 
Very hypertonic (hyperosmolar) 
Needs to be delivered via jugular catheters
25
Q

Partial or Peripheral Parenteral Nutrition

A

Only meets 40-70% of energy
Lower osmolarity
can be given peripherally

26
Q

parenteral nutrition in use

A

used in referral practices - Requires special expertise, equipment
Needs to be handled completely aseptically
Amino acids and dextrose ready to use
Meets 40-70% energy depending on case