Mnt Enteral Nutrition

Front 1

Delivery of formulated enteral or parenteral nutrients to maintain or restore nutritional status

Back 1

Nutrition Support

Front 2

When should nutrition support be considered?

Back 2

when a patient is unable to meet nutrition needs for more than a few days

Front 3

Provision of nutrients into the GI tract through a tube or catheter; may include oral supplements or meal replacements like Ensure/Boost

Back 3

Enteral Nutrition

Front 4

What is parenteral nutrition?

Back 4

provision of nutrients intravenously (through the veins)

Front 5

Nutrition support include which of the following?

A) enteral nutrition
B) parenteral nutrition
C) both enteral and parenteral nutrition
D) none of the following

Back 5

C. both enteral and parenteral nutrition

Front 6

Which of the following is a rationale and criteria for the provision of enteral nutrition?

A) Those who can't eat or can't eat enough
B) Should be the first consideration
C) If a person has a functioning GI tract (even part of it), you should consider enteral nutrition first
D) all of the above

Back 6

All of the above

Front 7

What is the rational and criteria for parenteral nutrition?

A) Reserved for nonfunctional or severe'y diminished GI function
B) Should be temporary until able to use enteral nutrition; however there are situations where parenteral nutrition may be life long
C) sometimes the only realistic option
D) all of the above

Back 7

D) all of the above

Front 8

What are the benefits of enteral nutrition vs. parenteral nutrition?

Back 8

-Better GI barrier function
-Preserved immunity
-Attenuate catabolic response
-Better blood glucose control
-Decreased rate of infection

Front 9

What are conditions that often require enteral nutrition?

Back 9

-Impaired nutrient ingestion
-Inability to consume adequate nutrition orally
-Impaired digestion, absorption, metabolism
-Severe wasting or depressed growth

Front 10

What is enteral nutrition access?

Back 10

the location of nutrient administration and type of enteral access device

Front 11

Enteral nutrition access depends on what?

Back 11

-Anticipated length of time of enteral feeding
-Risk for aspiration
-Patient's clinical status
-Presence or absence of normal digestion and absorption
-Patient's anatomy (obesity)
-Planned surgical intervention

Front 12

List some examples of enteral nutrition access.

Back 12

-Nasogastric route
-Nasoduodenal or nasojejunal route
-Percutaneous Endoscopic Gastrostomy (PEG)
-Laparoscopic/Fluroscopic techniques
-Surgically placed enterostomies (Gastrostomies and Jejunostomies)
-Multiple Lumen Tubes

Front 13

Difference between closed enteral system and open enteral system.

Back 13

Open enteral system: the container or bag is prefilled with sterile liquid formula by the manufacturer and ready to administer

Closed enteral system: person administering feeding opens and pours the feeding into the container or bag (higher risk for contamination)

Front 14

Which enteral system has a higher risk for contamination?

A) hang time
B) closed enteral system
C) open enteral system
D) enteral nutrition access

Back 14

C. open enteral system

Front 15

Length of time an enteral nutrition formula is considered to be safe for administration to a patient

4hrs--for open systems
24-48hrs--for closed systems

Back 15

Hang time

Front 16

What type of enteral nutrition is typically used for short term 3-4 weeks?

A) PEG tube
B) Nasoduodenal/Nasojejunal route
C) Nasogastric route
D) both b and C

Back 16

D. both b and c

Front 17

Which enteral nutrition route is most commonly used?

A) nasduodenal route
B) PEG tube
C) nasojejunal
D) nasogastric route

Back 17

D. nasogastric route

Front 18

This enteral route consist of going through the nose then into the stomach

A) nasogastric route
B) nasoduodenal
C) PEG tube
D) gastrostomies

Back 18

A. nasogastric route

Front 19

Nonsurgical technique for placing the tube directly into stomach through the abdominal wall using an endoscope and anesthesia.

A) nasogastric
B) nasoduodenal
C) gastrostomies
D) PEG tube

Back 19

D. PEG tube

Front 20

Suitability of a feeding formula should be evaluated based on what?

Back 20

-Functional status of the GI tract
-Energy and nutrient content and patients nutrition needs
-Type of protein, fat, and CHO, in the formula
-Presence of fiber
-Digestion and absorption capability of patient
-Clinical considerations such as fluid and electrolyte status and organ or system function
-Viscosity of the formula related to the tube size
-Cost effectiveness

Front 21

Name some types of formula composition used in enteral nutrition

Back 21

-Standard polymeric formulas
-High-nitrogen formula
-Elemental or predigested
-Specialized or disease specific formulas
-Modular components

Front 22

Combining separate nutrient sources or modifying existing formula

A) Standard formula
B) Modular components
C) Specialized/Disease Specific formula
D) Elemental/Predigested formula

Back 22

B) modular components

Front 23

Formula aimed at a specific disease associated formulas

A) Specialized/Disease Specific formula
B) Modular components
C) elemental/predigested formula
D) standard formula

Back 23

A) specialized/disease specific formula

Front 24

High-nitrogen formula are composed of __________ kcal from protein

A) 10-20%
B) 5-10%
C) 18-25%
D) 40-50%

Back 24

C. 18-25%

Front 25

What are some disease that may require a high-nitrogen formula?

A) burns, fistulas, sepsis, trauma
B) cancer
C) anorexia
D) congenital anomalies

Back 25

A. burns, fistulas, sepsis, trauma

Front 26

Concentrated Standard formulas are composed of _______ kcal/mL

A) 1-1.2
B) 3-5
C) 0.5-2
D) 1.5-2

Back 26

D. 1.5-2kcal/mL

Front 27

A formula contains high protein, low potassium, and low phosphorus. What kind of formula would this be classified as?

A) modular components
B) Specialized/Disease specific formula
C) Standard formula
D) Elemental/Predigested formula

Back 27

B. specialized/disease specific formula

Front 28

Administration or method selection of the formula is based on what?

Back 28

-Patient's clinical status
-Living situations
-Quality of life considerations

Front 29

Which of the following is NOT one of the types of administration/method selections for enteral feeding?

A. bolus
B. intermittent drip
C. hang time
D. continuous drip

Back 29

C. hang time

*hang time is the length of time an enteral nutrition formula is considered to be safe for adminstration to a patient

Front 30

Up to 500mL rapid delivery via large-bore syringe (3-4 times daily)

Back 30

bolus

Front 31

start with 100-150mL and increase as tolerated, 20-60 minutes, (4-6 times a day) via gravity drip or syringe

Back 31

intermittent drip

Front 32

Administered via infusion pump

For those who do not tolerate bolus or intermittent

Back 32

continuous drip

Front 33

Complications of enteral nutrition

Back 33

-access problems
-administration problems
-GI complications
-metabolic complications

Front 34

Potential Complications of Nasal Tubes

Back 34

-Esophageal strictures
-Gastroesophageal reflux resulting in aspiration pneumonia
-Incorrect position of the tube leading to pulmonary injury
-Mucosal damage at the insertion site
nasal irritation and erosion
-Pharyngeal or vocal cord paralysis
-Rhinorrhea, sinusitis
-Ruptured gastroesophageal varices in hepatic disease
-Ulcerations or perforations of the upper GI tract and airway

Front 35

What should be monitored when a patient is receiving enteral nutrition?

Back 35

-Weight (3x/wk)
-Signs and symptoms of edema (daily)
-signs and symptoms of dehydration (daily)
-fluid intake and output (daily)
-adequacy of enteral intake (2x/wk)
-abdominal distention and discomfort
-gastric residuals (every 4hrs) if appropriate
-serum glucose, calcium, electrolytes, blood urea nitrogen, creatinine (2-3x's/wk)
-stool outputs and consistency (daily)