Fluid Therapy

mild tachycardia

tacky mucous membranes

increased crt

normal jugular vein refill

normal peripheral pulse pressure

WNL/cool extremity temperature

skin tenting may or may not be present

BAR/QAR

signs of simple dehydration

mod-severe tachycardia

increased crt

prolonged jugular refill

reduced peripheral pulses

cool/cold extremity temperature

obtunded

skin tenting +/-

signs of volume depletiom

ICF volume

what volume is lost in dehydration

dehydration

occurs over a long time

volume depletion

acute injury/disease

ECF

what fluid space is lost in volume depletion

yes

can ICF volume be normal in volume depletion

resuscitation

rehydration

maintenance

ongoing losses

what are the 4 phases of fluid therapy

decreased venous return

decreased cardiac output

activation of RAAS

what are the homeostatic response to volume depletion

improve circulating volume and blood pressure

prevent circulatory collapse

improve o2 delivery to tissues

what is the goal of the homeostatic response to volume depletion

ECF

what needs to be replenished in volume depletion

aggressive IV fluid administration

what is usually required with volume depletion

IV fluid therapy

which route of administration is appropriate for resuscitation efforts?

5 percent

-ICF is compensating for the loss

clinical signs first observed with BLANK percent of total body water loss

-what does this mean physiologically

hypernatremia

what is a hallmark of dehydration

it becomes hypertonic

-water movement from the ICF

THIRST

with decreased water consumption what happens with the tonicity of the ecf

-what does this stimulate

(percent dehydration) times (body weight in kgs)

how to calculate the deficit in liters

5-7 percent loss

decreased skin turgor, slightly tacky membranes

mild dehydration

8-10 percent loss

depressed mentation, tacky mm, crt greater than 2-3 seconds

moderate dehydration

-more than 10 percent

-cool extremities, poor perfusion, CRT more than 4 seconds

severe dehydration

-initial bolus (1/2 deficit)--> maybe not in small animals

-replace remaining 1/2 over the next 12 hours

how do you rehydrate a patient

60ml/kg/day

maintenance for dogs

50 ml/kg/day

maintenance for horse

45 ml/kg/day

maintenance for cats

vomiting

diarrhea

what is an ongoing loss

shrinks

what happens when you put cells in hypertonic solution

swells

what happens when you put a cell in hypotonic solution

140 mEq/L

Na+ concentration in the ECF

4 mEq/L

K+ concentration in the ECF

110 mEq/L

Cl- concentration in the ECF

28 mEq/L

HCO3-

80-90ml/kg

give a fourth of it over 15 min, stop and see access, continue with another fourth if needed

what is a shock dose

how do you give it

8 percent of body weight

entire blood volume

shock dose is essentially.....

10ml/kg/site

what is the cut off for sub q fluids