Midterm 1 Part 5

Question 1

what are the 5 steps of initiation of nutritional support?

Answer 1

1. determine fluid requirement
2. determine energy requirement
3. select calorie sources
4. micronutrient requirements
5. select the route of administration

Question 2

why are fluids so important when providing nutritional support?

Answer 2

if there is no adequate fluid, the rest of your nutritional support will be compromised

Question 3

the daily fluid requirements are usually _______mL/kg, but may be more in patients who are _____

Answer 3

60
vomiting or having diarrhea or have renal dysfunction

Question 4

when giving fluids, why should you measure the intake and keep track of how much they are drinking?

Answer 4

because this can be a good indicator of how the patient is doing and you can figure out if they are receiving the required amount, if they need more, less, etc

Question 5

true or false: you should correct fluid deficiencies after you do assisted feeding

Answer 5

FALSE you should always correct deficits BEFORE you proceed with assisted feeding

Question 6

what should you use to determine the energy requirement when offering nutritional support?

Answer 6

the resting energy requirement (if you use the maintenance requirement it often overestimates the needs)

Question 7

receiving resting energy requirement allows the animal to:

Answer 7

maintain basal metabolic rate
maintain body temeprature
allows recovery from activity

Question 8

optimal distribution of calories depends on

Answer 8

species, palatability, digestibility, cost and availability, ease of use, specific disease process

Question 9

what is the optimal protein intake for dogs and cats in % of total calories

Answer 9

dogs: 25 to 45% of calories
cats: 30 to 50% of calories

Question 10

why is it useful to have a high fat content in a critical care diet?

Answer 10

you’re adding more calories per volume so the animal doesn’t need to eat as much . at adds calories while also adding palatability

Question 11

what is the optimal intake of fat for dogs and cats in regards to % of calories?

Answer 11

dogs: 20 to 60%
cats: 35 to 50%

Question 12

when is the only time you would include carbohydrates in a critical care diet? why are carbs not ideal as an energy source?

Answer 12

if the patient was sensitive to protein or fats and needed a substitue for energy requirements
carbs are not ideal because they may not be used efficiently during illness

Question 13

micronutrient requirements of citical illness best met by

Answer 13

commercial products, they are complete and balanced!

Question 14

what are the three routes for nutritional support?

Answer 14

voluntary intake
enteral (tube) feeding
parenteral (IV) feeding
**optimal route depends on underlying disease

Question 15

voluntary is the ideal route of nutritional support IF ????

Answer 15

nutrient requirements are being met (they are eating ENOUGH, you need to keep track of how much they are eating!!!)

Question 16

what are some steps you can use to maximize voluntary food intake?

Answer 16

hand feed small, frequent meals
offer highly palatable, aromatic foods
warm up the food
use calorie and nutrient dense commercial rations

Question 17

what kinds of drugs can you use to stimulate appetite?

Answer 17

mirtazapine, diazepam (valium), cyproheptadine (periactin)

Question 18

what are some disadvantages of enteral feeding?

Answer 18

long periods of transition, can’t use it if the GI tract is nonfunctional

Question 19

what are some advantages of enteral feeding?

Answer 19

more physiologic than IV
prevents villous atrophy
prevents bacterial translocation
less complex
fewer complications
cheaper

Question 20

how should you decide what kind of feeding tube to give a patient?

Answer 20

depends where the site of GI dysfunction is, how long you’re intening to feed the animal for, patient comformation and diseases, type of ration to bed fed (liquid/solid), clinical status of patient (can be the patient be anestheized)

Question 21

what are nasoesophageal tubes good for?

Answer 21

they are a tiny tube good for feeding liquids and they are good for short term nutritional support

Question 22

what are gastrostomy tubes good for?

Answer 22

they are bigger tubes so you can put bigger chunks through it, you can leave them in for a long time, can be permenant!

Question 23

after you’ve placed a feeding tube, what is the best way to reintroduce feed to them?

Answer 23

start with initial bolus feeding every 2 hours and give a small dilute volume. the goal is to feem 4 to 6 times a day

Question 24

what is one thing to remember about jejunostomy tubes?

Answer 24

they cannot be sent home with the owner, they require contant rate infusion

Question 25

what are some advantages of feeding IV?

Answer 25

bypass the GI tract, allows bowel rest, decreased risk of aspiration, may not require anesthesia, decrease risk of bleeding with a surgical procedure

Question 26

what are some disadvantages of IV feeding?

Answer 26

villous atrophy, bacterial translocation, complications like sepsis and hyperglycemia, you need special equipment and products, requires more care and more expensive

Question 27

if your patient undergoing nutritional support is to be removed from nutritional support, what is the first thing you should do?

Answer 27

before the removal of the tube or catheter you should measure how much the animal has eaten and compare it to the calculated requirements (you don’t want to have to replace a tube or catheter)
then gradually transition them to highly digestible low resiude diet (can take days or weeks)

Question 28

true or false: obesity is the most common form of malnutrition

Answer 28

true!

Question 29

what are two main causes of obesity

Answer 29

lack of exercise
eating excess calories

Question 30

true or false: in tact animls are more likely to be obese

Answer 30

false, neutered animals are more likely to be obese

Question 31

what are some breeds predispsed to obesity?

Answer 31

labs, shelties, beagles

Question 32

list some deleterious effects of obesity

Answer 32

muscoloskeletal problems, immunosuppression, glucose intolerance and insulin resistance, predispotition for hepatic lipidosis in cats, difficulty in drug dosing, increase risk in surgery, increased risk of cancer, shorter life spans

Question 33

in order for a weight loss plan to be effective the owner must be

Answer 33

completely convinced of the benefits

Question 34

what are the 6 steps to successful weight loss?

Answer 34

1. patient assessment
2. determine energy intake for weight loss
3. choose a weight loss ration
4. institute the weight loss program
5. monitor patient progress
6. transition to maintenance diet

Question 35

how do weight loss rations differ from normal maintenance rations?

Answer 35

differs in protein content and in fiber content

Question 36

optimal weight loss will maximize _____ and minimize _____

Answer 36

loss of adipose
loss of lean body mass

Question 37

what are some undesirable effects of high fiber diets?

Answer 37

increased frequency of defectation
abdominal distension, flatulence, poor coat quality, compromised nutrient absroption