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Flashcards in Fluid Therapy 2 Deck (45)
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1
Q
What is the recommended target fluid amount in 24 hrs?
A
80% within first 24 hrs
2
Q
What is the formula for fluid replacement?
A
% dehydration X BW (kg)= liters of fluid
3
Q
Concurrent losses should be added to what aspect of fluid replacement calculation?
A
Should be added to other losses/maintenance instead of immediate fluid replacement amount
4
Q
What is the typical fluid rate in equine?
A
10-20 ml/kg/hr (5-10 L/hr)
5
Q
What size catheter is recommended in a severely dehydrated patient?
A
10-12 G
6
Q
What size catheter is recommended in a moderately dehydrated patient?
A
12-14 G
7
Q
What size catheter is recommended in a miniature horse and weanlings with moderate dehydration?
A
14-16 G
8
Q
Define resuscitation
A
Replace estimated deficits rapidly within 1-2 hrs
9
Q
What is the rate that should be administered to a neonate in septic shock?
A
20 ml/kg over 10-20 minutes
10
Q
What is the maintenance fluid rate?
A
50-60 ml/Kg/day
11
Q
What is a situation where we would want to overhydrate the equine patient?
A
impaction, liquefaction of respiratory secretions
12
Q
What is the main source of K in a equine patient?
A
daily diet- ingest high quantity-excrete high quantities
13
Q
What do you see in terms of potassium when a horse is anorexic or in a state of colic?
A
Total body depletion of K
14
Q
Hypokalemia in horses is associated with what?
A
Alkalosis, decreased intake, sequestration loss, elevated plasma insulin
15
Q
What are the clinical effects of hypokalemia?
A
Arrhythmias, weakness, decreased intestinal motility
16
Q
What could cause hyperkalemia?
A
Hyperkalemic periodic paralysis, acidosis, uroabdomen, acute oliguric renal failure
17
Q
What is the rate of IV administration for K?
A
0.5 mEq/kg/hr
18
Q
Calcium is highly bound to what?
A
Proteins-mostly albumin
19
Q
What form of Ca are we most concerned about?
A
Ionized calcium
20
Q
T/F: Decreased in proteins can cause a decrease in total calcium while ionized calcium remains constant
A
TRUE
21
Q
What is seen in terms of Ca levels in an anorexic horse?
A
Total body depletion of Ca
22
Q
What is a major contributor to the development of synchronous diaphragmatic flutter?
A
Hypocalcemia
23
Q
SDF is associated with hyperresponsiveness of what nerve?
A
Phrenic nerve
24
Q
What are other disturbances seen with SDF?
A
Hypokalemia and metabolic alkalosis along with hypocalcemia
25
Q
What is the classic patient scenario of a horse with SDF?
A
endurance horse
26
Q
What are the clinical effects seen with hypocalcemia?
A
Muscle paresis, tremors, excitability, cramping, behavior changes, decreased myocardial contractility, hypotension
27
Q
What patients will you see hypercalcemia in?
A
Renal failure patients- chronic and oliguric acute renal failure
28
Q
If Ca supplementation is given too rapidly what is our main concern?
A
cardiotoxic effects- bradycardia
29
Q
What do sodium values represent?
A
water balance of the patient
30
Q
What is the most significant clinical sign seen with sodium imbalance?
A
Neurologic signs
31
Q
Define the following:
Hypertonic fluid loss
Hypotonic fluid loss
Isotonic fluid loss
A
Hypertonic loss: loss of electrolytes in excess of water
Hypotonic loss: loss of water in excess of electrolytes
Isotonic loss: loss of electrolytes in same ratio as serum
32
Q
What is the normal type of dehydration seen in exercise horses and what is seen if excessive dehydration is sustained?
A
Isotonic losses typically
Sweat becomes hypertonic after a point of dehydration met
33
Q
How should you treat acute sodium disturbances?
A
rapid restoration to normal Na status recommended
34
Q
If an animal has chronic sodium disturbances with CS how would you correct this?
A
correct slowly over days to one week to bring to normal
35
Q
If an animal has chronic sodium disturbances with no CS how would you correct this?
A
Likely patient is still within compensated range and therapy should be undertaken to slowly restore serum/Na values over a week
36
Q
What happens if there is rapid restoration of chronic hypernatremia?
A
Increase CNS intracellular volume significantly resulting in brain edema leading to herniation, permanent neurologic deficits and lysis of myelin
37
Q
What is the standard method of acid base interpretation?
A
Carbinocentric model
38
Q
What is the treatment of metabolic acidosis?
A
alkalinizing solution-typically lactate
(can undergo cystosolic gluconeogenesis in liver and mitochondrial oxidative metabolism in liver)
39
Q
What is the most common cause of lactic acidosis?
A
Tissue hypoxia
40
Q
At what point should you administer bicarbonate solution to treat acidosis?
A
17-18 mEq/L
41
Q
What factors of bicarbonate distribution would you use for a conservative, typical and younger animal?
A
conservative: 0.3
typical: 0.4
younger: 0.5
42
Q
How should bicarbonate be administered if it were to be used?
A
Traditionally half of deficit given over 60 minutes as isotonic solution
43
Q
What is a major contraindication to administration of bicarbonate?
A
Presence of respiratory compromise-hypoventilation
44
Q
What is a situation where metabolic alkalosis occurs?
A
Endurance racing-sweat losses or high GIT disease
45
Q
Endurance horses typically show a loss in what electrolytes?
A
Na & Cl resulting in retention of HCO3 and metabolic alkalosis