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VETT 134 Veterinary Anesthesia & Medical Assisting II
Wk 3 - Fluids/IV sets/prep
31
Veterinary Medicine
Not Applicable
06/10/2012

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Term
regurgitating
Definition
a passive process that may occur in an unconscious or conscious pt, is not preceded by retching, and results in a flow of stomach contents into the esophagus and mouth
Term
vomiting
Definition
an active expulsion of stomach contents, preceded by retching, that occurs only in conscious pts
Term
how do anesthetic agents affect cardiopulmonary fxn?
Definition
almost all anesthetic agents decrease the force of the heart muscle contraction (referred to as inotropy) and cause bradycardia. these factors in turn decrease the flow of blood from the heart (cardiac output). almost all agents also relax the muscle tone of blood vessels, which in turn cause an increase in the intravascular volume (vasodilatation). together the decreased cardiac output and vasodilatation cause hypotension and decrease the perfusion of tissues with blood
Term
In adult animals know what percent of body weight water makes the mass of the animal.
Definition
In adult animals about 60% of the body wt is water. Because of variation assoc with age and body fat content, young and lean pts have a somewhat higher percentage, while old and obese pts have a somewhat lower percentage
Term
Prescribed Rate
Definition
– the fluid administration rate ordered by the dr. expressed in milliliters per unit body wt per unit time. Most often mL/kg/hr
Term
Infusion Rate
Definition
– the rate at which fluids should be administered expressed in milliliters per unit time. Most often mL/hr. (Determined by multiplying the following: Patient body weight x prescribed rate. May also require a conversion factor to change pounds to kilograms.
Term
Delivery rate
Definition
– the # of drops of fluid that must fall inside the drip chamber of an administration set to deliver 1 mL of fluid expressed in drops per milliliter (gtt/mL). (Determined by looking on the packaging of the admin set)
Term
Drip Rate
Definition
the rate at which fluids should be administered expressed in drops per unit time. Most often gtt/min. (Determined by multiplying the following: Infusion rate x Conversion factor for hours to minutes x delivery rate.) If necessary to make it easier to set the rate, this figure may be reduced to drops per 10 or 15 seconds (usually calculated using a proportion) or drops per second (usually calculated by multiplying the drip rate (drops per minute) by the conversion factor for minutes to seconds
Term
Infusion Volume
Definition
the total vol of fluids to be administered expressed in mL or L. (Determined by multiplying the following 3 values: Pt body wt x prescribed rate x infusion time
Term
volume overload
Definition
Fluid admin too rapid – vol may overwhelm the circulation and cause problems such as pulmonary and cerebral edema
Term
Hemodilution
Definition
dilution of RBCs and plasma proteins from excessive fluid admin
Term
Overhydration
Definition
signs are ocular and nasal d/c, chemosis (edema and swelling of the conjunctiva), sq edema, increased lung sounds, increased respiratory rate, and dyspnea. Awake pt may exhibit coughing and restlessness. Although not commonly done, measurement of central venous pressure allows early detection of overhydration and is recommended for pts receiving more than this amount.
Term
Crystalloid Solutions
Definition
Routinely used in most anesthetized pts, except those that have low blood protein, low RBC mass, or a low platelet count. Contain water and sm-molecular-wt solutes such as electrolytes that pass freely through vascular endothelium. In addition to electrolytes, some contain dextrose and alkalinizing agents (buffers).

Types are –
Isotonic, Polyionic Replacement Solutions
Isotonic, Polyionic Maintenance Solutions
Normal Saline Solution
Hypertonic Saline Solutions
Dextrose Solutions
Term
Types of crystalloid solutions
Definition
Types are –
Isotonic, Polyionic Replacement Solutions
Isotonic, Polyionic Maintenance Solutions
Normal Saline Solution
Hypertonic Saline Solutions
Dextrose Solutions
Term
Colloid Solutions
Definition
used to support expansion of blood volume and blood pressure. During the perioperative period, colloids are used for pts with blood protein less than 3.5 g/dL.

2 basic types – synthetic colloid solutions and blood products
Term
To replenish volume lost through blood loss, give __ ml of fluids for every __ mL of blood lost
Definition
3 mL of fluids for every 1 mL of blood lost
Term
2 basic types of Colloid Solutions
Definition
synthetic colloid solutions - contain the lg molecular wt solutes dextran, pentastarch, hetastarch, or gelatin products. Hetastarch most commonly used.
blood products - whole blood or RBCs are used to support oxygen-carrying capacity of blood for pts that have profound blood loss. Plasma is primarily used to support expansion of blood volume or treat hypoproteinemia.
Term
Accepted IV administration rates for CRYSTALLOIDS during routine anesthesia and surgery
Definition
10 mL/kg/hr during the first hour followed by 5 mL/kg/hr for the remainder of the procedure
Term
why are routine anesthesia and sx rates significantly higher than the volume needed to maintain hydration?
Definition
they are intended to compensate for the vasodilation, decreased cardiac output, and increase in insensible fluid loss that can occur during anesthesia
Term
Crystalloid IV infusion rates for young, healthy pts with excessive bleeding or hypotension
Definition
40 ml/kg/hr (dogs and lg animals
20 ml/kg/hr (cats)
maximum of 1 hr, with half given over initial 15 minutes. many clinicians recommend an inital bolus of 10 to 20 mL/kg, reeval of pt, and addt'l boluses as needed.
Term
Crystalloid IV infusion rates for animals in shock
Definition
Dogs/lg animals - up to 90/mL/kg as fast as possible
Cats - 55 mL/kg
Many clinicians recommend an initial bolus of 10 to 20 mL/kg, reeval of pt, and addt'l boluses as needed
Term
Hypertonic Saline
Definition
Sometimes 3, 5, oand 7% hypertonic saline solns are given in sm volumes in pts w/ shock and blood loss when blood vol expansion is necessary.
Term
what is hypertonic saline used for and how is it given?
Definition
For blood vol expansion (for pts w/ shock and blood loss)in lg/sm animals, administer 7% hypertonic saline IV at a rate of 3 to 4 mL/kg slowly over a 5 min period, followed by admin of isotonic crystalloids
Term
how are synthetic colloids given?
Definition
IV in moderate volumes
Dogs/lg animals - 10 to 20 mL/kg/day as a slow bolus over 15 to 60 minutes for dogs/lg animals
Cats - 5 to 10 mL/kg/day as a slow bolus over 15 to 60 minutes
Term
Cautions with synthetic colloids
Definition
– infusion rate and total vol must be watched closely to prevent volume overload because colloids expand blood volume.
Can infrequently cause coagulation disorders and rarely allergic rxns
Given rapidly, hetastarch can induce nausea/vomiting
Term
Macrodrip sets
Definition
deliver fluids at 10 or 15 drops/mL
used to deliver fluids at infusion rates eual to or greater than 100 mL/hr or for pts weighing 10 kg or more
Term
Microdrip sets
Definition
deliver fluid at a rate of 60 drops/Ml and are used for infusion rates less than 100 mL/hr or for pts weighing less than 10 kg
Term
how do anesthetic agents affect cardiopulmonary fxn?
Definition
almost all anes. agents decrease the force of the heart muscle (inotropy) and cause bradycardia.

these factors decrease flow of blood from heart (cardiac output)

almost all agents also relax the muscle tone of blood vessels, which causes increase in intravascular volume (vasodilation)

Together the decreased cardiac output and vasodilation cause hypotension and decrease the perfusion of tissues with blood.
Term
How does administration of IV fluids support oxygen delivery?
Definition
Fluids increase circulating blood volume and cardiac output - 2 physiologic changes that support blood pressure and tissue perfusion
Term
Osmolarity
Definition
in health, a solute concentration or osmolarity of approx 300 mOsm/L is maintained in all body fluids. Conditions incl exercise, dehydration, heat stroke and some cases of vomiting/diarrhea that primarily involve water loss will increase osmolarity and other such as chronic CHF, in which lg quantities of solutes are lost, will decrease it
Term
Body fluid compartments as a % of total wt
Definition
total body water 60%, made of Intracellular fluid 40% and extracellular fluid 20 % (15% interstitial fluid, 5% intravascular fluid)
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