Term
| Fluids make up __% lean body weight? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are the three major fluid components of TBW? |
|
Definition
2/3 = ICF (intracellular fluid)
Interstitial
Intravascular |
|
|
Term
|
Definition
75% Interstitial
25% Intravascular (plasma) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Normal fluid losses for a dog or cat? |
|
Definition
40-60mL/kg/day
20mL of which is through urine |
|
|
Term
| 1 kg loss in body weight is equivalent to (what amount?) loss in body fluid? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Examples of abnormal fluid losses? |
|
Definition
-Dz with PU (diabetes)
-V/D
-increased respiration
-chronic/acute injury (ulcers/HBC)
-Reduced fluid intake |
|
|
Term
| Indicators of Hydration Status? |
|
Definition
-skin turgor
-MM
-HR
-PCV
-weight |
|
|
Term
|
Definition
| Hx fluid loss, but no findings on PE |
|
|
Term
|
Definition
| tacky MM, mild skin turgor |
|
|
Term
|
Definition
-dry MM
-moderate loss of skin elasticity
-slightly prolonged CRT
-slightly sunken eyes
-normal HR |
|
|
Term
|
Definition
-extreme loss of skin elasticity
-dry MM
-sunken eyes
-tachycardia |
|
|
Term
|
Definition
-significant signs of shock
-death imminent |
|
|
Term
| 1% increase in PCV = how much fluid loss? |
|
Definition
|
|
Term
| Normal PCV for dogs? cats? |
|
Definition
|
|
Term
| A PCV of .55 in a dog indicates a loss of __ fluids. |
|
Definition
|
|
Term
| Replace dehydration losses (slowly/rapidly). |
|
Definition
|
|
Term
| Replace hypovolemic losses (slowly/rapidly). |
|
Definition
| rapidly, but monitor heart |
|
|
Term
| Contraindications for fluid therapy? |
|
Definition
-risk of or pre-existing pulmonary edema
-pulmonary contusions
-brain injury
-congestive heart failure |
|
|
Term
|
Definition
-serous ocular/nasal discharge
-restlessness
-shivering
-tachycardia
-respiratory distress
-crackles/rales |
|
|
Term
|
Definition
| Normosol-R, "normal saline," 0.9% NaCl, LRS |
|
|
Term
|
Definition
| lactated ringer's solution |
|
|
Term
|
Definition
|
|
Term
| Tonicity of sub-Q fluids? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| ___ fluids should be used in hypovolemic patients. |
|
Definition
|
|
Term
| ___ fluids should be used in dehydrated patients. |
|
Definition
|
|
Term
| How can you help sub-Q fluids absorb faster? |
|
Definition
-warm up fluids
-gently massage area after administering |
|
|
Term
| What sort of animals might get IP fluids? |
|
Definition
|
|
Term
| What sort of animals might get IO fluids? |
|
Definition
|
|
Term
| How much sub-Q fluid can we at JJC administer without a doctor's order? |
|
Definition
|
|
Term
| Max amount of sub-Q fluids per site for dog? cat? |
|
Definition
|
|
Term
| Routes for IV fluid administration: |
|
Definition
-central (jugular, femoral to caudal vena cava)
-peripheral
-IO |
|
|
Term
| 3 phases of fluid therapy? |
|
Definition
-emergency phase
-replacement phase
-maintenance phase |
|
|
Term
| Purpose for emergency fluid therapy? |
|
Definition
| Treat shock and/or hypovolemia |
|
|
Term
| Amount of emergency fluids for dog? cat? |
|
Definition
dog: 90mL/kg/hr
cat: 60mL/kg/hr |
|
|
Term
| What can one do to facilitate giving the proper amount of emergency fluids to a large dog? |
|
Definition
|
|
Term
| 3 components of replacement phase? |
|
Definition
1. replace deficits
2. maintenance (normal losses)
3. replace continuing abnormal losses (V/D) |
|
|
Term
| Fluid deficit should be replaced over what time period? |
|
Definition
|
|
Term
| Formula for fluid deficit replacement: |
|
Definition
| (% dehydration)(BW kg)(10)= fluid deficit mL |
|
|
Term
|
Definition
| losses that can be measured (eg urine) |
|
|
Term
|
Definition
| losses that cannot or are hard to be measured (eg panting, sweating) |
|
|
Term
| Formula for maintenance fluid replacement? Alternate formula? |
|
Definition
40-60mL/kg/day (we use 50mL/kg/day)
1mL/#/hr |
|
|
Term
| How to estimate for ongoing abnormal losses? |
|
Definition
estimate volume of V/D, double it
**Jan never does this |
|
|
Term
| Ongoing fluid losses from GIT must be replaced as they occur. If a puppy vomits 50mL, it must receive ___mL in the next __hr period. |
|
Definition
|
|
Term
Estimate % dehydration:
HR= 190 Bpm
RR= 100 bpm
MM= pale, tacky
moderately decreased skin turgor |
|
Definition
| 10-12% because HR/RR increased |
|
|
Term
Estimate % dehydration:
HR= 100 Bpm (dog) or 170 Bpm (cat)
RR= 25 bpm
MM= tacky
mild decreased skin turgor |
|
Definition
| 5-6% because MM tacky, not dry |
|
|
Term
Estimate % dehydration:
HR= 100 Bpm (dog) or 170 Bpm (cat)
RR= 25 bpm
MM= dry
moderately decreased skin turgor
slightly prolonged CRT
slightly sunken eyes |
|
Definition
| 6-8% because MM dry, but HR still normal |
|
|
Term
Estimate % dehydration:
HR= 100 Bpm (dog) or 170 Bpm (cat)
RR= 25 bpm
MM= pink, moist
Owner says pet has not been drinking. |
|
Definition
| <5% because no PE findings, but Hx of fluid loss |
|
|
Term
| Definition and symptoms of phlebitis? |
|
Definition
-local venous inflammation
-inflammation, thickening, pitting edema, discomfort at site |
|
|
Term
| Signs of septicemia and bacterial endocarditis? |
|
Definition
| cardiac arrhythmias/murmurs, injected (red) MM, fever, leukocytosis |
|
|
Term
| Definition and signs of thrombosis? |
|
Definition
-clotting/coagulation
-vein stands up on its own, ropelike vein, cold/painful limb |
|
|
Term
| If thrombosis is suspected, what should you do to assess perfusion? |
|
Definition
| use Doppler to assess perfusion; also blue toe pads indicate poor perfusion |
|
|
Term
| 4 conditions in which a catheter should always be changed: |
|
Definition
-signs of irritation
-unexplained fever
-bandage is wet or soiled
-tubing kinked or has clots |
|
|
Term
| A multilumen central catheter allows one to perform several functions simultaneously. Describe these functions. |
|
Definition
-nutritional support
-meds/fluids
-CVP monitoring or blood samples |
|
|
Term
| If not using CRI, how often should you flush a central catheter? |
|
Definition
| at least 4 times a day with hep saline |
|
|
Term
|
Definition
Diffusion: flow of particles through a semi-permeable membrane from an area of high solute concentration to low solute concentration
Osmosis: flow of water through a semi-permeable membrane from an area of low solute concentration to an area of high solute concentration |
|
|
Term
| Electrolytes are measured in the (ICF, ECF)? |
|
Definition
|
|
Term
| Major ECF electrolytes? Most abundant? |
|
Definition
Major: Na, Cl, bicarbonate (CHO3)
Most Abundant: Na |
|
|
Term
| The distribution of water throughout the body is most affected by the electrolyte ___. |
|
Definition
|
|
Term
| ___ is the primary factor is determining ECF __ and osmotic ___. |
|
Definition
| Na, ECF volume, osmotic pressure |
|
|
Term
| Symptoms of hyponatremia: |
|
Definition
-muscle weakness
-lethargy
-mental depression
-nausea
-inappetance
-hypotension |
|
|
Term
| Symptoms of hypernatremia: |
|
Definition
-excessive thirst
-muscle weakness
-disorientation
-seizures
-coma |
|
|
Term
|
Definition
| K, Mg, phosphate (PO4^3-) |
|
|
Term
| Dominant electrolyte responsible for osmotic pressure in ICF? |
|
Definition
|
|
Term
| Which electrolyte is associated with nervous and cardiac functions? |
|
Definition
|
|
Term
|
Definition
| -muscle weakness, PU/PD, may affect insulin release |
|
|
Term
| What can cause hypokalemia? |
|
Definition
-anorexia
-excessive loss (V/D)
-alkalosis (movement from ECF->ICF) |
|
|
Term
| Increased pH is called... |
|
Definition
|
|
Term
| Symptoms of hyperkalemia? |
|
Definition
-class ECG changes (tall, tented T-wave)
-bradycardia
-weak myocardial contractility |
|
|
Term
| Decreased pH is called... |
|
Definition
|
|
Term
| What can causes hyperkalemia? |
|
Definition
-impaired renal excretion (K retained)
-urethral obstruction
-Addison's
-excessive K in fluid therapy |
|
|
Term
| Blood should be slightly ___ with a pH within the range of __ to __. |
|
Definition
|
|
Term
| Acid-base balance is maintained by (3 things): |
|
Definition
-blood buffers
-lungs
-kidneys |
|
|
Term
| On the pH scale, 14 is most ___ and 0 is most ___. |
|
Definition
14 = most alkaline/basic
0 = most acidic |
|
|
Term
| Lots of H+ indicates a ___ and a (low/high) pH. |
|
Definition
| H+ indicates an acid with a low pH |
|
|
Term
| Lots of OH- indicates a ___ and a (low/high) pH. |
|
Definition
| OH- indicates an alkaloid/base with a high pH. |
|
|
Term
| What does a CRT <1 sec indicate? |
|
Definition
| tachycardia from hypovolemia |
|
|
Term
| What does a CRT >2 sec indicate? |
|
Definition
|
|
Term
| Obese animals may appear (more/less) hydrated than they actually are. |
|
Definition
| obese animals appear more hydrated than they are |
|
|
Term
| With normal skin turgor, tented skin returns to its original shape within __ to __ sec. |
|
Definition
|
|
Term
|
Definition
|
|
Term
| decreased HCT/TPP indicate: |
|
Definition
| acute/chronic bleeding, hemodilution |
|
|
Term
|
Definition
|
|
Term
| increased HCT/TPP indicate: |
|
Definition
|
|
Term
| increased SG of urine may indicate: |
|
Definition
|
|
Term
| With isotonic crystalloid fluids, (amount) is lost from IV after (time). |
|
Definition
| 2/3 lost from vessels after 30min |
|
|
Term
| How is fluid therapy affected when a crystalloid is combined with a colloid? |
|
Definition
|
|
Term
| Na/K composition of replacement fluids? maintenance fluids? |
|
Definition
replacement: composition similar to plasma, with high Na, low K
maintenance: composition differs from plasma, low Na, high K |
|
|
Term
| Difference between Normosol-R and Normosol-M? |
|
Definition
Normosol-R(eplacement) - high Na, low K
Normosol-M(aintenance) - low Na, high K |
|
|
Term
| Most commonly used type of crystalloid fluid? (hint: type, not brand) |
|
Definition
| balanced replacement fluids |
|
|
Term
| Hypotensive shock should be treated with what tonicity of fluids? |
|
Definition
| hypertonic, to draw fluids into vascular system and increase volume/pressure |
|
|
Term
| Colloids consist of ___ starches. |
|
Definition
|
|
Term
| Some brand name colloids? |
|
Definition
|
|
Term
| Conditions treated with colloid fluids? |
|
Definition
| blood loss, hypoproteinemia |
|
|
Term
| According to Sirois text, what is the rule of thumb for using colloid fluids? |
|
Definition
|
|
Term
| Possible complications of colloid fluid therapy? Why may these occur? |
|
Definition
-bleeding tendencies
-aggravate coagulopathies
May occur because colloids decrease function of platelets which are needed for clotting. |
|
|
Term
| What can you give a patient receiving colloid fluid therapy to counteract possible complications? |
|
Definition
| plasma and other blood products to increase platelet function |
|
|
Term
| Patients with ___ should receive fluids rapidly. |
|
Definition
|
|
Term
| Patients with ___ should receive fluids slowly. |
|
Definition
|
|
Term
|
Definition
| systemic blood pressure is inadequate to deliver sufficient oxygen and nutrients throughout the body |
|
|
Term
| When adding something to a fluid bag, always label the bag with 6 things: |
|
Definition
-additive
-concentration
-amount
-your initials
-date
-time |
|
|
Term
| Oral fluid therapy is okay for what sort of patient? |
|
Definition
| mildly dehydrated, just needs maintenance fluids |
|
|
Term
| Negative aspects of sub-Q fluids? |
|
Definition
-not absorbed well by severely dehydrated patients
-can cause hypothermia
-smaller volumes |
|
|
Term
| Which route of fluid delivery has the most rapid effect on blood volume? |
|
Definition
|
|
Term
| Hypertonic solutions must be administered in... |
|
Definition
| a central vein, because blood will dilute the solution and minimize hemolytic effects |
|
|
Term
| What type of fluids can be administered IP? |
|
Definition
| isotonic crystalloids only |
|
|
Term
| Which bones are commonly used for IO fluid therapy? |
|
Definition
| femur, humerus, wing of ilium |
|
|
Term
| What type of fluids can be administered IO? |
|
Definition
|
|
Term
| How often should an IO cath be replaced? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| scanty, frequent urination |
|
|
Term
|
Definition
|
|
Term
|
Definition
increased BUN
AND
increased CREA |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| By the time azotemia occurs, what percent of kidney function is lost? |
|
Definition
|
|
Term
| What 2 things do you evaluate to assess renal function? |
|
Definition
|
|
Term
| What are 2 congenital bladder diseases? |
|
Definition
-Persistent Urachal Diverticulum
-Persistent Patent Urachus |
|
|
Term
| CS of Persistent Urachal Diverticulum? |
|
Definition
|
|
Term
| CS of Persistent Patent Urachus? |
|
Definition
-frequent urination
-hematuria, pollikiuria, and stranguria if there's a UTI
-urine leaking from belly button
-common in <12mo with recurrent bladder infections |
|
|
Term
| How to Dx bladder diseases? |
|
Definition
|
|
Term
| How to Tx bladder diseases? |
|
Definition
|
|
Term
|
Definition
| inflammation of the urinary bladder |
|
|
Term
|
Definition
-bacteria
-yeast
-predisposing factors like uroliths, obstructions, repro tract infection, catheterization, glucosuria |
|
|
Term
|
Definition
| excretion of glucose into the urine; may occur in diabetic pets |
|
|
Term
| What condition can occur in diabetic patients that would make them more likely to get a UTI? |
|
Definition
|
|
Term
| What is the most common cause of cystitis? |
|
Definition
| ascending route through the urethra |
|
|
Term
|
Definition
-pollakiuria
-stranguria/dysuria
-hematuria
-foul-smelling urine
-cloudy urine
-painful bladder
-more frequent licking of urethra |
|
|
Term
|
Definition
-UA
-Urine culture
-Pneumocystogram
-US - "snow globe"
-Cystoscope
-Bx of bladder |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is the "snow globe" effect when ultrasounding the bladder? |
|
Definition
| Bounce transducer on bladder; crystals or other sediment will become suspended like "snow" |
|
|
Term
| How to collect urine for urine culture? |
|
Definition
|
|
Term
|
Definition
-remove predisposing factors if possible
-Abx: 2wks, may need 4-6wks; do a FU 1-3d after finishing meds |
|
|
Term
| 3 most common types of uroliths: |
|
Definition
-struvite (magnesium phosphate)
-urate
-calcium oxylate |
|
|
Term
| Most common type of urolith in cats and dogs? |
|
Definition
| struvite (magnesium phosphate) |
|
|
Term
| What type of urolith can result from UTIs? |
|
Definition
| struvite (magnesium phosphate) |
|
|
Term
| What type of urolith is associated with alkaline urine? |
|
Definition
| struvite (magnesium phosphate) |
|
|
Term
| Some ___ uroliths are idiopathic. |
|
Definition
| struvite (magnesium phosphate) |
|
|
Term
| What type of urolith has a radiographic density of 2+ to 4+? |
|
Definition
| struvite (magnesium phosphate) |
|
|
Term
| How to Tx struvite (magnesium phosphate) uroliths? |
|
Definition
-s/d to lower pH, then c/d
-Abx if there's infection
-Sx |
|
|
Term
| Common brand name product to acidify pet's urine? |
|
Definition
|
|
Term
|
Definition
| for struvite uroliths - reduces pH |
|
|
Term
|
Definition
| give after Tx for bladder problem EXCEPT urate uroliths |
|
|
Term
|
Definition
| for urate uroliths - dissolves stones |
|
|
Term
| Urate uroliths are common in ___. |
|
Definition
|
|
Term
| What type of urolith is associated with acidic urine? |
|
Definition
|
|
Term
| What type of urolith has a radiographic density of 0 to 2+? |
|
Definition
|
|
Term
| How to Tx urate uroliths? |
|
Definition
-u/d diet (dissolves stones)
-allopurinol sid/tid
-Abx
-Sx (quicker relief) |
|
|
Term
|
Definition
-inhibits secretion of uric acid into the urine
-dissolves urate stones |
|
|
Term
| What type of urolith has a variable urine pH? |
|
Definition
|
|
Term
| What type of urolith has a radiographic density of 4+? |
|
Definition
|
|
Term
| What type of urolith may be caused by a too acidic diet? |
|
Definition
|
|
Term
| What type of urolith is common in Schnauzers? |
|
Definition
|
|
Term
| What type of urolith can only be treated with Sx? |
|
Definition
|
|
Term
| All uroliths removed from a patient must be sent in for ___ ___. |
|
Definition
| quantitative analysis - find out what type it is |
|
|
Term
|
Definition
| Feline Lower Urinary Tract Disease |
|
|
Term
|
Definition
-cystitis
-urethritis
-obstructions |
|
|
Term
|
Definition
-pollakiuria, stranguria, hematuria, or inability to urinate
-urinate outside of box
-licking of genital area
-if obstructed: loss of appetite, V/D, weakness, severe electrolyte imbalance |
|
|
Term
| CS of uremia, and what it leads to? |
|
Definition
-loss of appetite, V/D, weakness, severe electrolyte imbalance
-leads to acidosis, hyperventilation, cardiac abnormalities, shock, collapse and death in 3-5 days |
|
|
Term
| How to Dx an obstructed cat with FLUTD? |
|
Definition
-painful bladder
-hard, inflamed penis (purple, bright red)
-signs of uremia
-inability to express bladder |
|
|
Term
| How to Dx a non-obstructed cat with FLUTD? |
|
Definition
-painful bladder
-bladder is usually empty |
|
|
Term
| Other than palpation, how to Dx FLUTD? |
|
Definition
-rads (eg stones but no blockage)
-Labs:
--CBC
--Chem (^BUN,^CREA), electrolytes
--UA
--culture |
|
|
Term
| An obstructed cat needs (less/more) sedation? |
|
Definition
| LESS! can't excrete drugs properly |
|
|
Term
|
Definition
-sedate if needed
-catheterize, hydropropulsion
-monitor BUN/CREA/electrolytes
-cath stays in for 24-48hrs
-IV fluids |
|
|
Term
| Tx for non-obstructed cat? |
|
Definition
-treat primary cause if known
-acidifying diets
-anti-inflammatories for persistent hematuria |
|
|
Term
| IV fluids are given to an obstructed cat for 3 purposes: |
|
Definition
| -correct fluid deficit -correct electrolyte abnormalities -diuresis |
|
|
Term
| Important things to tell a client whose cat has FLUTD: |
|
Definition
-prophylactic measure to prevent recurrence
-Rx diet to keep pH 6.0
-encourage water intake
-monitor for recurrence |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
-infection
-chemical (poison, grapes, etc)
-shock
-trauma
-obstruction |
|
|
Term
|
Definition
-depression
-anorexia
-vomiting
-melena
-anuria or oliguria |
|
|
Term
|
Definition
|
|
Term
|
Definition
-Hx of exposure
-signs of uremia
-oliguria/anuria
-dorsal lumbar pain
-^BUN,^CREA
-absence of Hx of CRF
-Bx kidneys |
|
|
Term
|
Definition
-Tx cause if known
-relieve obstruction if present
-urinary cath places, monitor output
-IV fluids (taper off) |
|
|
Term
| What to monitor in a pt with ARF? |
|
Definition
-urine quantity/color/clarity
-PCV/TPP (hydration)
-electrolytes |
|
|
Term
| Prognosis of ARF depends on: |
|
Definition
-etiology
-severity
-intensity of therapy |
|
|
Term
| Definition of CRF (not abbreviation): |
|
Definition
| inability of kidney to perform normal function due to result of gradual, progressive loss of renal function over long period of time |
|
|
Term
|
Definition
-congenital
-infection
-parasites (Capillaria)
-immune-mediate (FIV)
-amyloid (Shar Peis)
-neoplasia
-toxins
-vascular Dz (FIP)
-infarction
-idiopathic
-diabetes |
|
|
Term
| How does amyloid protein affect kidneys? |
|
Definition
| it attacks kidney tissues and can lead to CRF |
|
|
Term
| What dog has problems with amyloid protein? |
|
Definition
|
|
Term
|
Definition
-PU/PD
-lethargy
-anorexia
-vomiting
-hypertension, arrythmias, tachypnea, hypothermia |
|
|
Term
|
Definition
-PU/PD
-signs of uremia
-^BUN,^CREA
-isothenuria
-anemia
-small kidneys |
|
|
Term
|
Definition
Urine SG = Blood SG
(normally urine SG is higher because the kidneys are excreting wastes!) |
|
|
Term
|
Definition
- general measures: avoid stress, fresh drinking water, vitamins in water
-dietary changes (low protein, low Na)
-Tx hyperphosphatemia (Amphogel, Azodyl)
-Tx anemia if needed (steroids, erythropoietin, blood transfusion)
-Tx vomiting w/Tagamet/Pepcid
-Tx uremia w/fluids |
|
|
Term
| What are Amphogel and Azodyl? |
|
Definition
-drugs that treat hyperphosphatemia associated with CRF
-take at least SID for life |
|
|
Term
| How to Tx anemia in pt with CRF? |
|
Definition
-no Tx if HCT >30 in dogs, >25 in cats
-steroids (Winstrol)
-erythropoietin (Epakatin, Epogen)
-blood transfusion |
|
|
Term
| Why might a blood transfusion be given to a pt with CRF? |
|
Definition
|
|
Term
| Important consideration if giving a blood transfusion to a cat? |
|
Definition
| Must match blood types with cats!! Not as important in dogs. |
|
|
