Chapter 8: Metabolism and Nutritional Needs of Surgical Patients

Question 1

Lack of oral food intake results in what?

Answer 1

Villous atrophy -occurs in as little as 1.5 days without eating
Don’t hold food in patients for >48hr

Question 2

Serum albumin concentration of less than ___ g/dL is associated with increased postop complications?

Answer 2

2g/dL

Question 3

How much of energy consumed by muscle tissue produces actual work?

Answer 3

20-30% (70-80% is heat)

Question 4

Sprinting greyhounds have a daily energy requirement of how many times RER?
How many times RER for sled dogs?

Answer 4

Greyhounds: 1.6 to 2x RER
Sled dogs: 5x RER

Question 5

What provides the most calories in dog food at 8.5kcal/g?

Answer 5

Fat
CHO and protein are 3.5kcal/g

Question 6

What is the difference between a polymeric and monomeric diet?

Answer 6

Polymeric = blenderized foods, isoosmolar
Monomeric diet does not require digestion before absorption, but is hyperosmolar

Question 7

When giving nutritional support IV, dextrose >___% and amino acids >____% need to be administered into a central vein as they are hyperosmolar?

Answer 7

Dextrose 10%
Amino acids 6.5%

Question 8

Daily energy requirement is a factor x RER. What is DER for a lactating bitch? For an adult dog doing heavy work? For a critical care patient?

Answer 8

Lactation = 4.0 to 8.0
Heavy work also 4.0-8.0
Critical care is just 1.0

Question 9

What is the factor x RER for daily requirement of an intact adult dog? A neutered adult? Obese prone?
What about for weight loss?

Answer 9

Intact: 1.6
Neutered: 1.4
Obese prone: 1.2
Weight loss: 1.0

Question 10

What % of hospitalized dogs suffer from malnutrition?

Answer 10

10% (less than humans!)

Question 11

What is uncomplicated starvation? Stressed starvation?

Answer 11

Uncomplicated = body lowers metabolic rate to decrease needs. Death takes weeks and is cardiac or respiratory failure.
Stressed = Metabolic rate high, no conservation of protein, inflammation, rapid malnutrition, increased sympathetic output/catabolism

Question 12

What is the daily water need for oral intake?

Answer 12

50-60mL/kg/day

Question 13

Healthy patients should receive what level of RER/diet?
What about traumatized patients?

Answer 13

Healthy/good BCS = normal RER and continue diet.
Trauma patients may have increased needs, up to 2x RER

Question 14

What are complications of parenteral nutrition?

Answer 14

IV issues, thromboembolism, infections, hyperglycemia (starvation can cause insulin resistance), refeeding syndrome (phosphorus!), electrolyte and acid/base disturbances

Question 15

Appetite stimulants can have what side effect?

Answer 15

Sedation