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Principles of Science > Clinical Nutrition > Flashcards

Clinical Nutrition Flashcards

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1
Q

What are the two needs for fluid therapy?

A

Replacement of lost fluidsMaintenance of needed fluids

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2
Q

What are maintenance fluids needed for?

A

Metabolic pathways

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3
Q

What are the ways in which fluid can be lost within the body?

A

Blood lossDehydrationExcessive urinationVomiting, diarrhoeaSequestered fluid

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4
Q

What percent of body weight is total body water?

A

60%

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5
Q

Describe the breakdown of total body water by compartments

A

1/3 of total body water in extracellular fluid- 3/4 of extracellular fluid in interstitial fluid- 1/4 of extracellular fluid in plasma2/3 of total body water in intracellular fluid

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6
Q

What is needed in order to decide if fluid therapy is needed and how to administer it?

A

Clinical historyPhysical exam findingsLaboratory tests - determining azotaemia or metabolic disturbances

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7
Q

What can give an idea of what is occurring with fluid loss?

A

Changing characteristics of pulse profile

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8
Q

What is shock?

A

Body compensating for loss of fluids

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9
Q

What is needed to bring an animal back from shock?

A

Rapid application of fluid - restore intravascular fluidsBolus - rapid application of fluid over 10-20 minutes

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10
Q

What would a bolus be used for in fluid therapy? IV drip?

A

Bolus - rapid reintroduction of fluid into intravascular fluidIV drip - slowly replaces fluids across all fluid compartments

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11
Q

Describe how a skin tent can determine a level of dehydration of an animal

A

Water stored in fat under the skin - loss of fluid causes loss of motility making tent stay longerToo much water then skin becomes gelatinous

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12
Q

Why are fluids required during anaesthesia?

A

Suppression of systems (CVS, respiratory and neurological) causing vasodilationInduced hypovolaemic state so need fluids to compensate

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13
Q

How can fluid therapy be used to help animals with azotaemia or intoxication?

A

Used to flush the system out by increasing glomerular filtration rate

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14
Q

Why are electrolytes needed in fluids?

A

Pure water would just lyse cells - need to match very closely what the body has lost

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15
Q

Describe the contents of fluids

A

WaterElectrolytes (sodium, chloride, potassium, magnesium and calcium)Buffers (lactate and citrate)Dextrose

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16
Q

What 4 things, other than replacing lost fluids, can fluid therapy be used for?

A

Correction of electrolyte disordersCorrection of acid-base disturbancesDelivery of drugsDeliver nutrients

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17
Q

What are the two fluid types classified by the fluid type?

A

CrystalloidColloid (natural and synthetic)

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18
Q

What are the three fluid types classified by tonicity?

A

IsotonicHypertonicHypotonic

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19
Q

What is the most common fluid therapy used?

A

Isotonic crystalloids

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20
Q

What is contained in crystalloid fluid?

A

Water and small molecules (<30 KD)

21
Q

How can crystalloid fluids be administered?

A

PeroralIntravenousSubcutaneousIntraosseusIntraperitoneal

22
Q

What are complications related to in crystalloid fluids?

A

Amounts of fluid used - too little or too much

23
Q

What is contained in synthetic colloids?

A

Water and large molecules (>30 KD)

24
Q

Why are synthetic colloid fluids useful for resuscitation of intravascular volume?

A

Generates colloid osmotic pressure which delays equilibration of fluid with other compartments

25
Q

What complications are included with synthetic colloid therapy?

A

Fluid overload and coagulopathy

26
Q

What can synthetic colloids contain?

A

Haemoglobin to provide oxygen

27
Q

What are natural colloids?

A

Blood products - fresh whole blood, packed red blood cells and fresh frozen plasmaConcentrated albumin solutions - human, canine and feline

28
Q

How long do bloods last in their varying states?

A

Fresh - use within 1 dayPacked - lasts 30 daysFrozen - lasts 3-5 years

29
Q

What are parenteral nutritions?

A

Mixture of amino acid solutions, dextrose and lipidsProvides energy and building blocks for protein synthesis

30
Q

What does tonicity determine in fluid therapy?

A

Distribution of fluid between compartments - what can move fluids from one compartment to another

31
Q

What do hypertonic fluids allow access to in fluid therapy?

A

Intracellular water

32
Q

What would application of hypotonic fluid intravenously cause?

A

Cellular oedema - fluid shifts to intracellular compartment

33
Q

What are the majority of cases that isotonic crystalloids are used for?

A

RehydrationResuscitation - hypovolaemia treatmentCorrection of acid/base electrolytesDeliver drugsInduce diuresis

34
Q

When is colloid use considered?

A

When rapid resuscitation is requiredWant to increase COPNeed effect to last longer than 1 hourUsed when animal is oedematous

35
Q

What is hypertonic saline used for?

A

Extremely rapid resuscitation

36
Q

What is mannitol most commonly used for?

A

Brain oedema - can also treat acute glaucoma and oliguric renal failure

37
Q

Why are hypotonic fluids not used very much?

A

Devil’s fluid - causes too many complications with electrolytes and cellular oedema

38
Q

How is parenteral nutrition used?

A

Uncommon in general practiceOnly used if convincing case of bowel failure present

39
Q

What are the two types of parentreal nutrition?

A

Total Parenteral Nutrition - 100% of energy requirements, very hypertonic and needs to be delivered by jugular cathetersPartial or peripheral parenteral nutrition - 40-70% of energy, lower osmolarity and can be given peripherally

40
Q

What is malnutrition?

A

Any disorder that results in inadequate or imbalanced nutrition associated with deficiencies or excess

41
Q

What effects of malnutrition will negatively impact overall survival of an animal due to illness or severe injury?

A

Loss of muscle massDecrease in protein synthesisCompromised immune functionDecreased wound healing

42
Q

What do sick animals catabolise instead of fat when deprived of sufficient calories?

A

Lean muscle mass

43
Q

Why are patients at an increased risk for rapid development of malnutrition?

A

Metabolic alterations associated with critical illness and animals refuse to take in sufficient calories

44
Q

What is a classical sign of nausea in cats and dogs?

A

Cats - hypersalivationDogs - repeated licking of the lips

45
Q

What is the only real way to provide nutrition to neonates?

A

Orogastric feeding tubes - inserted orally and passed all the way down to the stomach

46
Q

What are the most commonly used feeding tubes in practice?

A

Naso-oesophageal feeding tubes

47
Q

What are the drawbacks to naso-oesophageal feeding tubes?

A

Have to place Elizabethan or Buster Collars to prevent tube removalOnly liquid diets can be used

48
Q

What complications are associated with tube feeding?

A

Vomiting - GI tract can’t cope with feedingMechanical problems - tube obstruction can be commonIncision infectionContents leakage

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