Pharmaclogy Enteral And Parenteral Nutrition

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provision of liquid formula diets into the GI tract

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Enteral nutrition

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These types of feedings allow for more natural digestion in the stomach

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nasogastric, esophagostomy, gastrostomy

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this is a risk with nasogastric tubes

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Aspiration

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single nutrient formulas (protein, carbohydrate, or fat)

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Modular formulations

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"elemental" diets contain nitrogen in the form of free amino acids, carbohydrates as glucose polymers, and minimal amounts of fat as long-chain triglycerides, usually accounting for 3% or less of total calories. Used for a variety of GI diseases

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Monomeric formlations

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minimum digestion and produce minimal fiber in the colon. indicated for clients with partial bowel obstruction, inflammatory bowel disease, radiation enteritris, bowel fistulas and short bowel syndrome

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Oligomeric formulations

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most commonly prescribed complete formula, enteral preparations. Such formulations contain complex nutrients: protein (e.g., casein and soy protein), carbohydrates (e.g., corn syrup solid, maltodextrins), and fat (vegetable oil or milk fat) and are preferred for clients who have a fully functional GI tract and few or no specialized nutrient requirements. They should not be used in clients with a malabsorption problem. These formulations are preferred because the hyperosmolarity of the oligomeric preparations causes more GI problems than the polymeric formulations

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Polymeric formulations

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indicated for clients with specific disease states such as genetic errors of metabolism (e.g., phenylketonuria, homocystinuria, maple syrup urine disease) or acquired disorders of nitrogen accumulation (e.g., cirrhosis or chronic renal failure), and for clients who are catabolic because of injuries or infection

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Specialized formulations

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these compounds ared added to formulations to enhance immune response

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omega 3 fatty acids, arginie, glutamine and nucleotides

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a condition in which more nitrogen is excreted than is taken in, indicating the wasting of tissue

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negative nitrogen balnace

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IV approach to complete nutrition. the administration of a nutritionally adequate hypertonic solution that consists of glucose, protein hydrolase, minerals and vitamins

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total parenteral nutrition

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for clients who need moderate nutritional support, temporary measures to provide appropriate balance for clients who have mild deficits or NPO

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Peripheral vein parenteral nutrition (PPN)

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for clients with nonfunctioning GI tracts, cannot use oral route for more than 7 days, limited peripheral access. Acute pancreatitis, GI tract obstruction, major trauma

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total parenteral nutrition (TPN)

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necessary to promote the production of proteins (anabolism), to reduce protein breakdown (catabolism), and help promote wound healing

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amino acids

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body cannot synthesize

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essential amino acids

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can be synthesized from a nitrogen source

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nonessential amino acids

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needed for growth and development

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amino acids

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not synthesized in adequate amounts during growth periods

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semiessential amino acids (histidine, arginine)

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this occurs if dextrose is administered without lipids as the primary source of calories

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hyperglycemia

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primary source of calories for the client

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carbohydrates and lipids

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Dextrose alone increases this

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rate of metabolism and production of CO2

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fat should constitute what percentage of the diet?

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30%

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Carbohydrates should constitute what percent of the diet?

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55%

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Protein should constitute what percent of the diet?

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15%

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fat emulsions are derived from:

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soybean or safflower oil

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What are the 2 functionsj of IV fat emulsions in parenteral nutrition

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supply essential fatty acids and to be a source of energy or calories

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Decrease in red and white blood cells; hair and skeletal abnormalities; defective tissue growth

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copper deficiency symptoms

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Neuropathy, confusion, impaired glucose tolerance, ataxia

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chromium deficiency symptoms

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Defective growth, nausea, vomiting, weight loss, skin rash, CNS alterations (ataxia, seizures)

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manganese deficiency symptoms

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Muscle aches, pain or tenderness, cardiomyopathy

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selenium deficiency symptoms

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Nausea, vomiting, diarrhea, weakness, anorexia, growth retardation, anemia, hypogeusia, rash, depression, eye lesions, defective wound healing, and hepatosplenomegaly

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zinc deficiency symptoms

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vitamin dosages

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depends on client needs