Fluid Therapy

Question 1

What percent of the body is made up of water?

Answer 1

60%

Question 2

What percent of the body’s water is intracellular?

Answer 2

40%

Question 3

What percent of the body’s water is extracellular?

Answer 3

20%

Question 4

Of the body’s extracellular water, how much is intravascular?

Answer 4

1/4

Question 5

Of the body’s extracellular water, how much is interstitial?

Answer 5

3/4

Question 6

What physical exam findings would you assess for hydration/dehydration?

Answer 6

skin turgor, CRT, MM color

Question 7

What is mild dehydration?

Answer 7

~5%, minimal loss of skin turgor, semidry mucous membranes, normal eyes

Question 8

What is moderate dehydration?

Answer 8

~8%, moderate loss of skin turgor, dry mucous membranes, weak rapid pulses, sunken eyes

Question 9

What is severe dehydration?

Answer 9

~10%, considerable loss of skin turgor, tachycardia, extremely dry mucous membranes, weak/thready pulses, low blood pressure, at 12%, sunken eyes and altered level of consciousness

Question 10

How is hydration deficit calculated?

Answer 10

% dehydration (as a decimal) x wt in kg = ___ L (volume in liters)

Question 11

How are maintenance fluids calculated?

Answer 11

kg x 40-60ml/kg/day = ml/day
ml/day + estimated ongoing losses (V/D) + hydration deficit = ml/day
ml/day divided by 24 hours = ml/hour

Question 12

What 3 values need to be known to calculate a fluid rate?

Answer 12

hydration deficit, maintenance needs, ongoing losses

Question 13

Shock blouses are given at ___________ in dogs.

Answer 13

80-90ml/kg

Question 14

Shock boluses are given at ___________ in cats.

Answer 14

50-55ml/kg

Question 15

How are boluses calcuated?

Answer 15

kg x ml/kg = ml total to give

Question 16

How should boluses be given?

Answer 16

give 1/4 of total amount then reassess

Question 17

If 50% of shock bolus is not causing significant improvement, what can be added to fluids to help?

Answer 17

a colloid

Question 18

What fluids are appropriate for SQ fluids?

Answer 18

use isotonic crystalloids only

Question 19

What are the signs of overhydration?

Answer 19

increased respiratory rate, increased lung sounds/crackles on lung auscultation, pitting edema, increased blood pressure, chemosis, body weight increase of more than 10 percent

Question 20

What is the drip rate for a micro drip set?

Answer 20

60 drops/ml

Question 21

What is the drip rate for a macro drip set?

Answer 21

15 drops/ml

Question 22

Which fluids are crystalloids?

Answer 22

Normosol R, Plasmalyte, Physiologic saline, Lactated Ringers

Question 23

What kind of crystalloids are Normosol R, Physiologic saline, and Lactated Ringers?

Answer 23

isotonic crystalloids

Question 24

Which fluids are colloids?

Answer 24

hetastarch, dextran 70, oxyglobin, plasma, albumin, whole blood

Question 25

What type of colloids are hetastarch, dextran 70, and oxyglobin?

Answer 25

synthetic colloids

Question 26

What type of colloids are plasma, albumin, and whole blood?

Answer 26

natural

Question 27

Once given, where do crystalloids go in the body?

Answer 27

they enter all body fluid compartments

Question 28

When are isotonic crystalloids used?

Answer 28

shock, vomiting, diarrhea, pancreatitis

Question 29

When are hypotonic crystalloids used?

Answer 29

can be used to treat hypernatremia or conditions where sodium retention is a problem, not suitable for hypovolemic shock

Question 30

When are hypertonic crystalloids used?

Answer 30

useful in treating shock and intracranial edema

Question 31

Most isotonic crystalloids leave the __________________ space within 30 minutes.

Answer 31

intravascular space

Question 32

Hypotonic fluids hydrate the ________________ space.

Answer 32

extracellular space

Question 33

Hypertonic fluids cause fluid to move out of the ______________________.

Answer 33

interstitial space/intracellular space into the intravascular space

Question 34

Which isotonic crystalloid shouldn't be used in liver disease?

Answer 34

Lactated Ringers

Question 35

Colloids contain _____________________________.

Answer 35

large molecules that work to hold fluid in the vasculature

Question 36

How is volume of blood transfusion calculated?

Answer 36

Volume to transfuse= 90ml/kg (dog) or 60ml/kg (cat) X weight in kg X (desired PCV minus patient PCV divided by PCV of donor blood)

Question 37

What is the maximum time a blood transfusion should be completed in?

Answer 37

4 hours

Question 38

When are colloids used?

Answer 38

to treat anemia

Question 39

What should blood transfusion be started at?

Answer 39

rate started slowly, 1ml/kg for 10-15 minutes

Question 40

What is a blood transfusion increased to after a slow start?

Answer 40

2ml/kg/hr

Question 41

Sodium bicarbonate is added to fluids to correct ____________.

Answer 41

metabolic acidosis

Question 42

Why do we add potassium to fluids?

Answer 42

supplement for potassium deficits or prevent potassium deficits

Question 43

Why should calcium be given slowly IV?

Answer 43

can cause cardiac arrythmias, arrest and hypotension