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Clinical Nutrition Flashcards

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
What complications are included with synthetic colloid therapy?
Fluid overload and coagulopathy
26
What can synthetic colloids contain?
Haemoglobin to provide oxygen
27
What are natural colloids?
Blood products - fresh whole blood, packed red blood cells and fresh frozen plasmaConcentrated albumin solutions - human, canine and feline
28
How long do bloods last in their varying states?
Fresh - use within 1 dayPacked - lasts 30 daysFrozen - lasts 3-5 years
29
What are parenteral nutritions?
Mixture of amino acid solutions, dextrose and lipidsProvides energy and building blocks for protein synthesis
30
What does tonicity determine in fluid therapy?
Distribution of fluid between compartments - what can move fluids from one compartment to another
31
What do hypertonic fluids allow access to in fluid therapy?
Intracellular water
32
What would application of hypotonic fluid intravenously cause?
Cellular oedema - fluid shifts to intracellular compartment
33
What are the majority of cases that isotonic crystalloids are used for?
RehydrationResuscitation - hypovolaemia treatmentCorrection of acid/base electrolytesDeliver drugsInduce diuresis
34
When is colloid use considered?
When rapid resuscitation is requiredWant to increase COPNeed effect to last longer than 1 hourUsed when animal is oedematous
35
What is hypertonic saline used for?
Extremely rapid resuscitation
36
What is mannitol most commonly used for?
Brain oedema - can also treat acute glaucoma and oliguric renal failure
37
Why are hypotonic fluids not used very much?
Devil's fluid - causes too many complications with electrolytes and cellular oedema
38
How is parenteral nutrition used?
Uncommon in general practiceOnly used if convincing case of bowel failure present
39
What are the two types of parentreal nutrition?
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
What is malnutrition?
Any disorder that results in inadequate or imbalanced nutrition associated with deficiencies or excess
41
What effects of malnutrition will negatively impact overall survival of an animal due to illness or severe injury?
Loss of muscle massDecrease in protein synthesisCompromised immune function Decreased wound healing
42
What do sick animals catabolise instead of fat when deprived of sufficient calories?
Lean muscle mass
43
Why are patients at an increased risk for rapid development of malnutrition?
Metabolic alterations associated with critical illness and animals refuse to take in sufficient calories
44
What is a classical sign of nausea in cats and dogs?
Cats - hypersalivationDogs - repeated licking of the lips
45
What is the only real way to provide nutrition to neonates?
Orogastric feeding tubes - inserted orally and passed all the way down to the stomach
46
What are the most commonly used feeding tubes in practice?
Naso-oesophageal feeding tubes
47
What are the drawbacks to naso-oesophageal feeding tubes?
Have to place Elizabethan or Buster Collars to prevent tube removalOnly liquid diets can be used
48
What complications are associated with tube feeding?
Vomiting - GI tract can't cope with feedingMechanical problems - tube obstruction can be commonIncision infectionContents leakage

Principles of Science (9 decks)

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