Fluid Management

Question 1

What are methods of fluid intake?

Answer 1

-drinking
-food
-metabolism

Question 2

What are methods of fluid output?

Answer 2

-urine
-faeces
-respiration
-skin

Question 3

What is fluid maintenance value?

Answer 3

50ml/kg/day

Question 4

What are sensible losses, what is the range for this?

Answer 4

-fluid output from urine and faeces
-the body can adjust to the fluid losses

30-40ml/kg/day

Question 5

What are insensible losses, what is the range for this?

Answer 5

-fluid output from the skin and respiration
-body cannot adjust from the loses

10-20ml/kg/day

Question 6

What is degradation of fluids?

Answer 6

-animal has problems balancing input and output of fluid
-can cause dehydration
-initially fluid is lost from the blood

Question 7

What are the 3 main ways of assessing hydration?

Answer 7

-clinical examination
-urine testing
-blood testing

Question 8

What is a clear sign of dehydration that can be seen when carrying out an examination?

Answer 8

Skin tenting
Should return to normal within 1-2 seconds

Question 9

What urine analysis is carried out in patients?

Answer 9

-amount of urine being passed
(1-2ml/kg/hr)
-specific gravity ranges
(1.015-1.045 / 1.035-1.060)

Question 10

What blood tests can be carried out for urine patients?

Answer 10

-PCV
(37-55 / 24-45)
-creatinine
-haemoglobin
-electrolyte levels

Question 11

What is metabolic acidosis, and signs shown?

Answer 11

-where an acid state in the body occurs due to altered metabolism, unable to excrete acid or losing excess alkali

-diarrhoea, renal failure, shock.

Question 12

What is metabolic alkalosis, and signs shown?

Answer 12

-where an alkaline state is the body occurs due to altered metabolism, and losing excess acid

-vomiting stomach contents

Question 13

What is respiratory acidosis, and signs shown?

Answer 13

-where an acid state in the body occurs when respiratory system cannot excrete acid

-respiratory obstruction, acute respiratory failure, anaesthetic problems

Question 14

What is respirator alkalosis, and signs shown?

Answer 14

-where an alkaline state in the body occurs when respiratory system loses excess acid

-pain, stress, hyperthermia

Question 15

How is the volume of fluid administration calculated?

Answer 15

Maintenance volume (+deficit volume) (+volume of ongoing losses)

Question 16

When is a deficit volume used, and what is the formula?

Answer 16

-required when animal is dehydrated

-10ml/kg/1% dehydration

Question 17

When is volume of ongoing losses used, and what is the formula used?

Answer 17

-replaces fluids loss through ongoing vomiting, diarrhoea, or plasma loss through burns/scalds

-4ml/kg/vomit to diarrhoea or %burns

Question 18

How is fluid rate calculated?

Answer 18

Fluid volume/day = fluid volume/hour
/24 hours

Fluid volume/hour = fluid volume/minute
/60 minutes

Fluid/minute x drops/ml = drops/minute

60 seconds = 1 drop every x seconds
/drops/minute

Question 19

What are the 3 replacement fluid solutions?

Answer 19

-crystalloids
-colloids
-blood/blood products

Question 20

What does crystalloids solution contain and when is it used?

Answer 20

-solution containing water and electrolytes

-used to rectify fluid and electrolyte loss, and balance abnormal body pH

Question 21

What is colloids solution and when is it used?

Answer 21

-solution containing large molecules, such as plasma expanders

-anaemia patients (dogs only)

Question 22

When is whole blood fluids provided?

Answer 22

-haemorrhage
-anaemia
-haemolysis

Question 23

When is plasma fluids provided?

Answer 23

-burns
-hypovolaemia

Question 24

What are the 5 routes of administration?

Answer 24

-oral
-intravenous, cephalic, saphenous, jugular, ear
-sub cutaneous
-intraperitoneal
-intraosseous

Question 25

Advantages and disadvantages of providing oral administration?

Answer 25

-not invasive -anyone can administer -not as accurate -may vomit it up

Question 26

Advantages and disadvantages of providing IV administration?

Answer 26

-accurate -can deliver large amounts -invasive -can be ripped out or tangled -potential site of infection

Question 27

Advantages and disadvantages of providing sub-cut administration?

Answer 27

-dont need to be hospitalised -low skills required -invasive -patients not happy with injections

Question 28

Advantages and disadvantages of providing intraosseous administration?

Answer 28

-can deliver large amounts of fluid -skilled vet required

Question 29

How is an IV catheter placed?

Answer 29

-site prep (shave and clean) -raise vein and stabilise limb -insert needle at 45 degree angle -once in vein flush with saline and drawback -tape catheter into place -apply bandage

Question 30

What equipment is needed to set up a drip?

Answer 30

-ppe -syringe -needle -catheter -tape -fluid bag -drip stand -fluid pump -bandage material -swabs

Question 31

How should drip lines be managed and cared for?

Answer 31

-use sterile materials -catheter changed every 48-72 hours -dressing changed as required -check bag of fluid is right, in date and clear -check admin site for swelling, bruising or pain -check line for kinks, blockages and any interference

Question 32

How should patients receiving fluids be monitored?

Answer 32

-hydration levels -monitor TPR and mucous membranes -record urine output and specific gravity -monitor PCV -monitor on going losses -record all findings

Question 33

What are signs of over-hydration?

Answer 33

-soft moist cough -dyspnoea, tachypnoea, tachycardia -lethargy -runny nose -decreased PCV -increased urine output