Question

In detail explain what physical parameter you use to assess the hydration status in your patient. Detail different percentages of dehydration, and the signs you see on the examination. The patient is an 8lb feline, isn't show shock or vomiting or diarrhea. the cat is said to be 10% dehydrated. Explain the intravenous fluid administration thoroughly.

Answer 1

1. The physical parameters that are assessed in dehydration are :-

- skin turgor , in dehydration the skin turgor is rough

- mucous membrane, in dehydration the mucous membrane are dry

- orbit , in dehydration orbits are sunken

- capillary refill time , in dehydration the capillary refill time is more than 3 seconds

- urine output , in dehydration urine output decreases less than 30 ml per hour

- Heart rate ,in dehydration the heart rate is tachycardia with weak pulse

- Blood pressure, in dehydration the blood pressure is low

2. Different percentages of dehydration :-

<5%

Normal PE with history of fluid loss (not prolonged)

5%

Tacky or dry MM, history of fluid loss

7%

Dry MM, prolonged skin tent, tachycardic, history of fluid loss (somewhat prolonged)

10%

Dry MM, prolonged skin tent, tachycardic with weak to thready pulse, hypotension, history of fluid loss (somewhat prolonged)

12% or higher

Dry MM, prolonged skin tent, tachycardic or bradycardic with weak to absent pulse, hypotension, decreased temp +/- cool extremities, diminished/abnormal mentation, sunken eyes, history of marked fluid loss.

3. Intravenous fluid administration include :-

Isotonic:

have the same osmolality as body fluids and are most often used to replace extracellular volume (simple dehydration)

Hypotonic:

have an osmolality less than body fluids and are used most often to hydrate cells (hypertonic dehydration, required water replacement)

Hypertonic:

have as osmolality greater than body fluids and are used most often to increase extracellular fluid volume (replace electrolytes, treat shock.