Maintenance

Why do we do fluid therapy? (2)

1. Stabilization

2. Support blood pressure during anesthesia

Remember that only a — of the fluid(crystalloid) we give remains in circulation after equilibrium.

¼

what happens if u give too little fluid therapy (4)

1. Hypotension

2. Shock

3. Ischemia

4. Organ dysfunction (Kidney)

what happens if u give too much fluid therapy (4)

1. Edema

2. Poor wound healing

3. GI dysfunction

4. Pulmonary dysfunction

5. Hemodilution

6. overhydration

7. Volume Overload

patients at risk for hemodilution (3)

1. Anemic (PCV < 20)

2. Hypoproteinemic (TP <3.5)

3. Large blood loss during sx

what are the signs of overhydration (7)

1. Ocular and nasal discharge

2. Chemosis

3. SQ edema

4. Increased lung sounds

5. Increased resp rate

6. Dyspnea

7. Coughing and restless when awake

volume overload Overwhelms the circulation causing (2)

1. pulmonary edema

2. cerebral edema

what patient is at greatest risk of fluid overload (3)

1. <5kg

2. > 1hr procedures

3. Renal/Heart disease

whats wrong

chemosis

whats wrong

SQ edema

how to prevent fluid therapy complications? (5)

1. Proper equipment

2. Use fluid pump

3. Label fluid bag and monitor amount given

4. Monitor for signs of overhydration

5. Calculations to provide appropriate amounts specific to the patient

what are the fluid types (3)

1. colloids

2. crystalloids

3. blood products

colloids have — molecular solutes

large

colloids — freely diffuse

a. do

b. don’t

b. don’t

colloids maintain blood volume by pulling fluid from —

interstitium

when are colloids supposed to be used (3)

1. Hypoproteinemic patients

2. Low PCV

3. When blood pressure can not be maintained with crystalloids or other medications alone

what is a synthetics colloid

contain the very-large-molecular-weight solutes

colloids Should not be used in patients that are at high risk for (5)

1. adverse effects

2. preexisting kidney disease

3. SIRS

4. sepsis

5. coagulation disorders

examples of colloids (5)

1. hetastarch

2. dextran

3. pentastarch

4. gelatin

5. pentaspan

blood products are for (4)

1. Anemia

2. Hypoproteinemia

3. Coagulation

4. Thrombocytopenia

examples of blood products are (3)

1. Plasma

2. Whole Blood

3. Packed RBC’s

crystalloid have — molecular solute

small

crystalloids — freely diffuse

a. do

b. don’t

a. do

crystalloids are similar to —

ECF

crystalloids have lower — and — and more —

Na+, Cl-, K+

define isotonic crystalloids

Solute concentration similar to blood plasma

define polyionic crystalloids

several ions

When blood loss occurs, at least — mL of crystalloid fluids must be given for every — mL of blood lost.

3 ml, 1 ml

define balanced crystalloid

Solute profile similar to ECF

what are some examples of balanced Isotonic  Polyionic Replacement Crystalloids (3)

1. Lactated Ringers solution (LRS)

2. Plasma-lyte A (148)

3. Normosol-R

whats an example of an isotonic unbalanced replacement crystalloid

saline

why is saline unbalanced

it has only Na and Cl, and H2O

saline is used for (3)

1. hypochloremic metabolic alkalosis

2. hypercalcemia

3. administering blood transfusions

what is 5% Dextrose in water (D5W) for

Correct free water deficits that accompanies simple dehydration or heat stroke

define free water deficits

means replacing pure water that the body has lost without adding extra electrolytes like sodium or chloride.

what is the equipment needed for fluid therapy (4)

1. IV catheter and placement supplies

2. Fluid bag of selected fluid type

3. Drip set

4. +/- Fluid pump

what needs to be calculated before fluid therapy begins (4)

1. Patient’s weight

2. Prescribed rate

3. infusion rate

4. drip rate

procedure for fluid therapy (5)

1. Catheter Selection

2. catheter Placement

3. Selection of Fluid Type

4. Selection of Drip Set

5. Calculating fluid rate with a drip set

what is the drip set for an animal larger than 10 kg

10 drops/ml

what is the drip set for an animal smaller than 10 kg

60 drops/ml

prescribed rate aka

dosage

what is the prescribed rate in dogs

5 mls/kg/hour

what is the prescribed rate in cats

3 mls/kg/hour

CRI stands for

Constant Rate Infusion

define CRI

A system used to deliver a constant steady rate of medication to a patient over a set period of time

what are 2 ways to do a CRI

1. fluid pump

2. syringe pump

whats this called

syringe pump

what drugs commonly used in CRI (6)

1. Antibiotics

2. Analgesics

3. Anesthetic agents

4. Combinations (Analgesics and Anesthetics)

5. Vasopressors

6. inotropes

define inotropes

increases contractility

Always label ALL syringes containing injectable agents (4)

1. with name of patient

2. name of drug

3. drug concentration

4. volume of drug in syringe

what does the acronym DVMRC stand for (5)

1. D: Prescribed dose of drug

2. V: Volume of bag that you will put drug into

3. M: Mass of patient

4. R: Infusion rate  (You may need to calculate)

5. C: Concentration of drug

what is the acronym DVMRC for

calulating CRI

for anesthetic intervention guidelines in cats what temp is considered normal

38

for anesthetic intervention guidelines in cats what temp is considered critical (2)

1. less than 30

2. more than 40

for anesthetic intervention guidelines in cats what temp is considered investigate (2)

1. less than 37

2. more than 39

for anesthetic intervention guidelines in dogs what temp is considered normal (range)

38

for anesthetic intervention guidelines in dogs what temp is considered investigate (2)

1. less than 37

2. more than 39

for anesthetic intervention guidelines in dogs what temp is considered critical (2)

1. less than 33

2. more than 40

for anesthetic intervention guidelines in cats what heart rate is considered normal (range)

130 - 170

for anesthetic intervention guidelines in cats what heart rate is considered investigate (2)

1. less than 100

2. more than 200

for anesthetic intervention guidelines in cats what heart rate is considered critical (2)

1. less than 80

2. more than 225

for anesthetic intervention guidelines in small dogs what heart rate is considered normal (range)

100 - 120

for anesthetic intervention guidelines in medium dogs what heart rate is considered normal (range)

70 - 100

for anesthetic intervention guidelines in large dogs what heart rate is considered normal (range)

50 - 70

for anesthetic intervention guidelines in small dogs what heart rate is considered investigate (2)

1. less than 80

2. more than 150

for anesthetic intervention guidelines in medium dogs what heart rate is considered investigate (2)

1. less than 60

2. more than 100

for anesthetic intervention guidelines in large dogs what heart rate is considered investigate (2)

1. less than 40

2. more than 120

for anesthetic intervention guidelines in small dogs what heart rate is considered critical (2)

1. less than 60

2. more than 180

for anesthetic intervention guidelines in medium dogs what heart rate is considered critical (2)

1. less than 40

2. more than 150

for anesthetic intervention guidelines in large dogs what heart rate is considered critical (2)

1. less than 35

2. more than 150

for anesthetic intervention guidelines in cats what respiratory rate is considered normal

12

for anesthetic intervention guidelines in cats what respiratory rate is considered investigate

less than 10

for anesthetic intervention guidelines in cats what respiratory rate is considered critical

less than 4

for anesthetic intervention guidelines in dogs what respiratory rate is considered normal (range)

8 - 15

for anesthetic intervention guidelines in dogs what respiratory rate is considered investigate

less than 8

for anesthetic intervention guidelines in dogs what respiratory rate is considered critical

less than 4

for anesthetic intervention guidelines in cats what SPO2 is considered normal

more than 95

for anesthetic intervention guidelines in cats what SPO2 is considered investigate

less than 95

for anesthetic intervention guidelines in cats what SPO2 is considered critical

less than 90

for anesthetic intervention guidelines in dogs what SPO2 is considered normal

more than 95

for anesthetic intervention guidelines in dogs what SPO2 is considered investigate

less than 95

for anesthetic intervention guidelines in dogs what SPO2 is considered critical

less than 90

for anesthetic intervention guidelines in cats what ETCO2 is considered normal (range)

35 - 40

for anesthetic intervention guidelines in cats what ETCO2 is considered investigate (2)

1. less than 30

2. more than 50

for anesthetic intervention guidelines in cats what ETCO2 is considered critical (2)

1. less than 25

2. more than 70

for anesthetic intervention guidelines in dogs what ETCO2 is considered normal (range)

35 - 40

for anesthetic intervention guidelines in dogs what ETCO2 is considered investigate (2)

1. less than 30

2. more than 50

for anesthetic intervention guidelines in dogs what ETCO2 is considered critical (2)

1. less than 25

2. more than 70

for anesthetic intervention guidelines in cats what SAP is considered normal

120

for anesthetic intervention guidelines in cats what SAP is considered investigate (2)

1. less than 85

2. more than 170

for anesthetic intervention guidelines in cats what SAP is considered critical (2)

1. less than 80

2. more than 200

for anesthetic intervention guidelines in dogs what SAP is considered normal

120

for anesthetic intervention guidelines in dogs what SAP is considered investigate (2)

1. less than 85

2. more than 170

for anesthetic intervention guidelines in dogs what SAP is considered critical (2)

1. less than 80

2. more than 200

for anesthetic intervention guidelines in cats what MAP is considered normal

100

for anesthetic intervention guidelines in cats what MAP is considered investigate (2)

1. less than 65

2. more than 130

for anesthetic intervention guidelines in cats what MAP is considered critical (2)

1. less than 60

2. more than 150

for anesthetic intervention guidelines in dogs what MAP is considered normal

100

for anesthetic intervention guidelines in dogs what MAP is considered investigate (2)

1. less than 65

2. more than 130

for anesthetic intervention guidelines in dogs what MAP is considered critical (2)

1. less than 50

2. more than 150