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| – a substance that conducts an electric current in solution, All ions are electrolytes |
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| all fluid contained w/in the tissues except for the fluid found w/in lymph and blood vessels |
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| How is the level of dehydration estimated, or determined, in a patient? |
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Definition
<5% - no signs detectable
6 – 7% - skin sl inelastic and doughy
8-9% - skin has lost elasticity, gums are tacky, eyes are sl sunken in, animal is subdued
10-12% skin remains tented when pinched, eyes are sunken in orbits, gums are dry, CRT of blanched gums is delayed, animal depressed and weak
12 -15% - animal is recumbent and in shock, death is imminent |
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| level of dehydration - no signs detectable |
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Definition
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| level of dehydration - skin sl inelastic and doughy |
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Definition
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| level of dehydration - skin has lost elasticity, gums are tacky, eyes are sl sunken in, animal is subdued |
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| level of dehydration - skin remains tented when pinched, eyes are sunken in orbits, gums are dry, |
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| level of dehydration - animal is recumbent and in shock, death is imminent |
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| Replacement fluid formula |
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Definition
| Body wt (kg) x % dehydration x 1000 = fluid deficit (ml) |
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| Estimating maintenance fluid needs |
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| 2.5 ml/kg/hr or 60 ml/kg/day |
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| Estimating ongoing fluid losses |
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Definition
- sometimes challenging to estimate
- rule of thumb – often 2x what you might think
- ex: dog vomits 50 ml fluid, actual loss is prob 100 ml
- through hx, frequency/volume of V/D very important |
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| Calculating Total Fluid Needs |
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| 7) Why is water so important to the body? |
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Definition
- involved in almost all of the metabolic processes in the body
- major component of blood and found inside all cells (intrcellular)
- found outside the cell (extracellular)
- serves many fxns in body
- lubricant for body tissues
- circulatory and transport mediu,
- chemical reactant in digestion (hydrolysis)
- excreted as sweat and evaporated during panting to assist in temp reg
- medium in which biochemical rxns of metabolism occu, such as those involved in the growth, repair, and maintenance of cells |
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| What are the 4 processes, or exits, by which water normally leaves the body? |
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Definition
Urine
Fecal material
Sweat (esp horses)
Respiration (esp dogs who are panting) |
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Definition
Important to know route/extent of loss
- skin turgor test – be aware – animals w/ low body fat or obese may have misleading skin turgor
- MM – should be moist
- HR/Pulse – weak HR/thready pulse
- Reduced jugular distension (esp w/ horses)
- reduced CRT |
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| Evaluating hydration through Lab tests |
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Definition
- PCV –
- TPP/TP
- urine SG
all of these can be increased w/ dehydration |
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Definition
solns that contain electrolyte and non-electrolyte substances that are capable of passing through cell membranes and can enter all body fluid compartments. Admin results in rapid equilibralization of fluid between the intravascular and interstitial spaces. Routinely used in vet med due to versatility and relatively low cost.
Can be classified as replacement or maintenance solns.
Replcament solns resemble extracellular fluid in content
Maint solns contain less sodium/more potassium than replacement fluids |
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Definition
Isotonic
Hypotonic
Hypertonic |
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| What are the 4 processes that control water exchange between plasma and interstitial fluid? |
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Definition
Diffusion
Facilitated diffusion
Osmosis
filtration |
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| Why is fluid balance dependent on electrolyte balance? |
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Definition
| Osmolalities of all body fluids are equal; changes in solute concentrations are quickly followed by osmotic changes |
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| What are the 4 pressures involved in Starling’s Law? |
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Definition
| blood hydrostatic pressure (BHP), interstitial fluid hydrostatic pressure (IFHP), blood colloid osmotic pressure (BCOP), and interstitial fluid osmotic pressure (IFOP) |
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| What is Starling’s Law as it applies to cardiac fxn? |
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Definition
Starling’s Law states that the stroke volume of the heart increases in response to an increase in the volume of blood filling the heart (the end diastolic volume) when all other factors remain constant.
The increased volume of blood stretches the ventricular wall, causing cardiac muscle to contract more forcefully (the so-called Frank-Starling mechanisms). The stroke volume may also increase as a result of greater contractility of the cardiac muscle during exercise, independent of the end-diastolic volume. The Frank-Starling mechanism appears to make its greatest contribution to increasing stroke volume at lower work rates, and contractility has its greatest influence at higher work rates.
This allows the cardiac output to be synchronized with the venous return, arterial blood supply and humoral length[1] without depending upon external regulation to make alterations. |
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Definition
| an excess of K+ in the blood |
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| – an excess of sodium in the blood |
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Definition
| a deficiency of K+ in the blood |
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Definition
| a deficiency of sodium in the blood |
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Definition
| decreased volume of circulating blood |
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Term
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Definition
| degree of fullness or congestion; describes the degree of elasticity of the skin |
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Definition
| the act of separating into ionic components (NaCl – Na and Cl) |
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| 3) List and discuss some of the indications for fluid therapy. How is the hydration status of a patient evaluated? |
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Definition
Eval hydration by PE:
Important to know route/extent of loss
- skin turgor test – be aware – animals w/ low body fat or obese may have misleading skin turgor
- MM – should be moist
- HR/Pulse – weak HR/thready pulse
- Reduced jugular distension (esp w/ horses)
- reduced CRT
Evaluating hydration through Lab tests
- PCV –
- TPP/TP
- urine SG
all of these can be increased w/ dehydration |
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| 3) List and discuss some of the indications for fluid therapy. |
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Definition
Hydration status
Fluid balance
Replacing electrolytes and nutrients
And maint an open IV line for administering medications |
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| 1) What are the 3 volumes that are calculated to determine the volume of fluid to administer? |
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Definition
Hydration deficit
Maintenance requirement
Ongoing losses |
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| Starling’s Law of the capillaries |
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Definition
According to this law, the control mechanism for water exchange between
plasma and interstitial fluid consist of four types of pressure: blood hydrostatic and colloid osmotic pressure on one side of the capillary membrane and interstitial fluid hydrostatic and colloid osmotic pressure on the other side. |
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| 6) What routes of administration may be used for fluid therapy? How is the appropriate route determined for each patient? |
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Definition
- IV – preferred when loss has been great or disorder severe. Allows quicker, more precise delivery of fluids than other routes. Req IV cath and closer monitoring
- SQ
- Oral
- IP
- IO |
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| How often should an IV catheter be flushed |
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Definition
| Should be flushed q 6 – 12 hrs with heparinized saline (5U/ml of 0.9saline |
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| 9) Any product containing the electrolyte _____________ should be given by slow IV administration to prevent cardiac complications. |
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Definition
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| 10) List and briefly describe the clinical uses of fluid additives used to enhance the therapeutic effects of IV fluid solutions |
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Definition
- Sodium bicarbonate fluid additive - - alkalizing agent to correct metabolic acidosis and as an adjunctive therapy for tx of hypercalcemia or hyper kalemia.
Normal serum bicarb is 24 mEq/L. Reqd amt for supp are calc by meas bicarb (or CO2) level and subtracting that value from 24. Difference called bicarbonate deficit.
Formula to determine # mEq sodium bicarbonate to admin:
Bicarb supp (mEq) = bicarb deficit x 0.6 x wt (kg)
When no lab measurements available must make empirical est based on clinical judgment
Adverse side effects_ may incl metabolic alkalosis, hypokalemia, hypocalcemia, and hypernatremia
Potassium Chloride fluid additive – tx or prevention of potassium deficits
Adverse side effects – may include hyperkalemia, which is manifested by muscle weakness and cardiac conduction disturbances – can be life threatening
Calcium Supplements fluid additive
Calcium gluconate and calcium chloride – used for the tx of hypocalcemia that may result from various conditions, which may include parathyroid gland disorders, milk fever, eclampsia, and excessive sweating in horses.
Calcium in combo w/ phosporus, magnesium, potassium and dextrose is used to tx cattle w/ grass tetany, milk fever, downer cow syndrome, etc
Adverse effects result from hypercalcemia and may incl hypotension, cardiac arrythmias and cardiac arrest. Usually result of too rapid infusion of calcium
50% Dextrose
caloric supplementation in sm animal pts and tx of ketosis in ruminants
a 50% soln of dextrose contains 500 mg/ml
formula to prepare percent solns:
desired strength/available strength = how much you are going to use/how much you are going to make
Vitamin supplements fluid additives
Restoration of normal levels of water-soluble vitamins
Adverse effects – incl hypersensitivity rxns to thiamine in the complex |
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Term
| Sodium bicarbonate fluid additive |
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Definition
- alkalizing agent to correct metabolic acidosis and as an adjunctive therapy for tx of hypercalcemia or hyper kalemia.
Normal serum bicarb is 24 mEq/L. Reqd amt for supp are calc by meas bicarb (or CO2) level and subtracting that value from 24. Difference called bicarbonate deficit.
Formula to determine # mEq sodium bicarbonate to admin:
Bicarb supp (mEq) = bicarb deficit x 0.6 x wt (kg)
When no lab measurements available must make empirical est based on clinical judgment
Adverse side effects_ may incl metabolic alkalosis, hypokalemia, hypocalcemia, and hypernatremia |
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| Potassium Chloride fluid additive |
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Definition
tx or prevention of potassium deficits
Adverse side effects – may include hyperkalemia, which is manifested by muscle weakness and cardiac conduction disturbances – can be life threatening |
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| Calcium Supplements fluid additive |
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Definition
Calcium gluconate and calcium chloride – used for the tx of hypocalcemia that may result from various conditions, which may include parathyroid gland disorders, milk fever, eclampsia, and excessive sweating in horses.
Calcium in combo w/ phosporus, magnesium, potassium and dextrose is used to tx cattle w/ grass tetany, milk fever, downer cow syndrome, etc
Adverse effects result from hypercalcemia and may incl hypotension, cardiac arrythmias and cardiac arrest. Usually result of too rapid infusion of calcium |
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| 50% Dextrose fluid additive |
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Definition
caloric supplementation in sm animal pts and tx of ketosis in ruminants
a 50% soln of dextrose contains 500 mg/ml
formula to prepare percent solns:
desired strength/available strength = how much you are going to use/how much you are going to make |
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| Vitamin supplements fluid additives |
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Definition
Restoration of normal levels of water-soluble vitamins
Adverse effects – incl hypersensitivity rxns to thiamine in the complex |
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| Compare and contrast water-soluble vitamins and fat-soluble vitamins. |
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Definition
Water-soluble - All of the B vitamins -- thiamin, riboflavin, niacin, pantothenic acid, biotin, B-6, folic acid and B-12 -- are water soluble, as is vitamin C. After you consume these vitamins, they are metabolized along with your food and ready for absorption into the bloodstream from your small intestine. Because of their water solubility, the B vitamins and vitamin C do not need special structures to carry them through the bloodstream and often are absorbed by means of simple diffusion.
There are four fat-soluble vitamins: A, D, E and K. Like fats themselves, fat-soluble vitamins cannot be absorbed directly into the bloodstream unaccompanied because they are not soluble in water and blood is an aqueous solution. Just like fat, or lipid, molecules, fat-soluble vitamins need the presence of bile salts to keep them emulsified in the aqueous solution of your intestines and they then have to be transported by vehicles called chylomicrons, which are made up of a combination of protein and fat able to move through water.
With the exception of B-12, water-soluble vitamins are not stored in the body for later use. Once your body has sufficient levels of a given vitamin to facilitate its immediate needs, the excess vitamins are excreted as waste in your urine. Because of your inability to store water-soluble vitamins, it is important to eat a healthy, balanced diet every day. Conversely, the fat-soluble vitamins are stored in your body's fat stores, or adipose tissue, as well as your liver.
Since you cannot store water-soluble vitamins, symptoms of toxicity from excess intake are rare. The fat-soluble vitamins carry a risk of toxicity because of their capacity for long-term storage. Vitamin A excesses have been linked to birth defects, anorexia, dry and itchy skin, alopecia, bone and muscle pain and conjuctivitis |
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