Mosby Ch 23 Fluid Therapy

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Florida Institute of Animal Arts access

fluid therapy

used to correct fluid deficits, electrolyte disturbances, and acid-base imbalances

Total Body Water (TBW)

60% (of the body is composed of fluid)

(3 components of) TBW

ICF (intracellular fluid, interstitial fluid), Plasma (intravascular fluid), ECF (extracellular fluid)

Homeostasis

the maintenance of stable internal conditions

osmosis

process of movement of water across a cell membrane

(3 major) extracellular electrolytes

sodium, chloride, bicarbonate

sodium (is responsible for)

determining ECF volume and osmotic pressure

(3 major) intracellular electrolytes

potassium, magnesium, phosphorous

potassium (extracellular electrolytes responsible for)

osmotic pressure within the ICF (which electrolyte)

hypernatremia

excessive sodium (dehydration)

hyponatremia

low sodium levels (creates a low osmolality)

Hypoxemia

deficient amount of oxygen in the blood

Hypoventilation

deficient movement of air in and out of the lungs (causing hypercapnia)

Hypotension

low blood pressure

Hypovolemia

deficient volume of circulating blood

Hypothermia

abnormally low body temperature

five hypos

hypoxemia, hypoventilation, hypotension, hypovolemia, hypothermia

(3 groups of) fluids

crystalloids, artificial colloids, blood products

crystalloids

contain small molecules that can pass thru semipermeable membrane and enter all body compartments

isotonic

without causing shrinkage or swelling of the cells

hypotonic

causes cells to swell

hypertonic

causes cell to shrink

artificial colloids

contain large molecules that do not readily pass through a semipermeable membrane (used for expanding blood volume)

artificial colloids solutions

hydroxyethyl starches (hetastarch, pentastarch), dextrans, gelatins (gelofusin, haemaccel, vetaplasm)

2 most common indications for fluid therapy

dehydration, hypovolemia

(goal in Tx of acute) hemorrhagic hypovolemia

stop hemorrhage and support the cardiovascular system (restoration of vascular volume)

shock

condition in which systemic blood pressure is inadequate to deliver oxygen and nutrients to vital tissues and organs

(goal in Tx of) shock

identify cause, focus on restoring blood volume and improving tissue perfusion (fluid therapy is the foundation)

dehydration

loss of body water, often accompanied electrolyte imbalances

routes of fluid therapy

oral, SQ, IV, intraosseous,

evaluation factors of fluid therapy

fluid loss, volume of fluid loss, rate of fluid loss, fluid solution selected, volume and rate of administration, patient status

SQ fluid sites

over the dorsal neck and cranial trunk, where loose connective tissue is abundant (area where limbs join the trunk should be avoided)

IV fluid sites (easy to prepare, catheterize, bandage)

cephalic, medial femoral, and saphenous veins

intraosseous sites

femur, humerus, and wing of the ilium

laboratory test (used to evaluate degree of anemia vs dehydration)

packed cell volume (PCV), total plasma protein (TPP)

whole blood components

cellular portion (RBC, WBC, platelets) and plasma

Fresh Whole Blood (FWB contains)

RBC, WBC, platelets, plasma proteins, and coagulation factors (Tx for acute hemorrhage, hypovolemic shock, thrombocytopenia)

Stored Whole Blood (SWB contains)

RBC, Plasma proteins (Tx for anemia with hypoproteinemia, hypovolemic shock)

Packed Red Blood Cells (PRBC contains)

RBC, reduced plasma (Tx to increase red cell mass in symptomatic anemia)

Platelet Rich Plasma (contains)

Platelets, few RBC's & WBC's, some plasma (Tx for life threatening bleeding)

Fresh Frozen Plasma (FFP contains)

plasma, albumin, all coagulation factors (Tx for coagulation disorders/factor deficiencies)

Frozen Plasma (FP contains)

plasma, albumin, stable coagulation factors (Tx for stable coagulation factor deficiencies)

Cyopreciptate (CRYO contains)

factor VIII, vWF (vonWillebrand factor), fibrinogen, fibronectin (Tx for von Willebrand & hemophilia A patients)

Oxyglobin solutions

sterile solution of purified , polymerized bovine hemoglobin in a modified lactated ringer's solution (increases oxygen delivery to tissues, has no need for blood typing)

canine blood types

DEA (erythrocyte antigen)1.1, 1.2, and 3-13 (total 13 specific antigens or blood types)

universal canine blood donor

DEA 1.1- negative (ideally, also DEA 1.2- negative and DEA 7- negative)

antigen-antibody reaction (blood type which causes)

DEA 1.1- negative

cat blood types

A, B, and AB (no universal donor, type B has a very strong anti-A alloantibodies)

hypoxemia, hypoventilation, hypotension, hypovolemia, hypothermia

five hypos

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