Midterm 1 Part 5 Flashcards
what are the 5 steps of initiation of nutritional support?
- determine fluid requirement
- determine energy requirement
- select calorie sources
- micronutrient requirements
- select the route of administration
why are fluids so important when providing nutritional support?
if there is no adequate fluid, the rest of your nutritional support will be compromised
the daily fluid requirements are usually _______mL/kg, but may be more in patients who are _____
60
vomiting or having diarrhea or have renal dysfunction
when giving fluids, why should you measure the intake and keep track of how much they are drinking?
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
true or false: you should correct fluid deficiencies after you do assisted feeding
FALSE you should always correct deficits BEFORE you proceed with assisted feeding
what should you use to determine the energy requirement when offering nutritional support?
the resting energy requirement (if you use the maintenance requirement it often overestimates the needs)
receiving resting energy requirement allows the animal to:
maintain basal metabolic rate
maintain body temeprature
allows recovery from activity
optimal distribution of calories depends on
species, palatability, digestibility, cost and availability, ease of use, specific disease process
what is the optimal protein intake for dogs and cats in % of total calories
dogs: 25 to 45% of calories
cats: 30 to 50% of calories
why is it useful to have a high fat content in a critical care diet?
you’re adding more calories per volume so the animal doesn’t need to eat as much . at adds calories while also adding palatability
what is the optimal intake of fat for dogs and cats in regards to % of calories?
dogs: 20 to 60%
cats: 35 to 50%
when is the only time you would include carbohydrates in a critical care diet? why are carbs not ideal as an energy source?
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
micronutrient requirements of citical illness best met by
commercial products, they are complete and balanced!
what are the three routes for nutritional support?
voluntary intake
enteral (tube) feeding
parenteral (IV) feeding
**optimal route depends on underlying disease
voluntary is the ideal route of nutritional support IF ????
nutrient requirements are being met (they are eating ENOUGH, you need to keep track of how much they are eating!!!)
what are some steps you can use to maximize voluntary food intake?
hand feed small, frequent meals
offer highly palatable, aromatic foods
warm up the food
use calorie and nutrient dense commercial rations
what kinds of drugs can you use to stimulate appetite?
mirtazapine, diazepam (valium), cyproheptadine (periactin)
what are some disadvantages of enteral feeding?
long periods of transition, can’t use it if the GI tract is nonfunctional
what are some advantages of enteral feeding?
more physiologic than IV
prevents villous atrophy
prevents bacterial translocation
less complex
fewer complications
cheaper
how should you decide what kind of feeding tube to give a patient?
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)
what are nasoesophageal tubes good for?
they are a tiny tube good for feeding liquids and they are good for short term nutritional support
what are gastrostomy tubes good for?
they are bigger tubes so you can put bigger chunks through it, you can leave them in for a long time, can be permenant!
after you’ve placed a feeding tube, what is the best way to reintroduce feed to them?
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
what is one thing to remember about jejunostomy tubes?
they cannot be sent home with the owner, they require contant rate infusion
