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21 Cards in this Set
- Front
- Back
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What is enteral nutrition for?
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It is preferred method of meeting nutritional needs IF THE CLIENT'S GI TRACT IS FUNCTIONING by providing physiological, safe, and economical nutritional support.
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How do entrerally fed clients receive formula?
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via nasogastric, jejunal, or gastric tubes.
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When is jejunal feeding preferred over gastric feeding?
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When there is a risk of gastric reflux which leads to aspiration.
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Indications for Enteral Nutrition
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-Cancer (Head and neck and Upper GI)
-Critical Illness/Trauma Neurological and muscular disorders (brain neoplasm, CVA, dementia , myopathy, Parkinson's) -Gastrointestinal Disorders -Respiratory Failure With Prolonged Intubation -Inadequate Oral Intake (Anorexia nervosa, difficulty chewing, swallowing, severe depression) |
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Indications for Parenteral nutrition
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-Nonfuntional Oral intake
-Extended Bowel Rest (entrocutaneous fistula, inflammatory bowel disease exacerbation, severe diarrhea, moderate to severe pancreatitis) -Preoperative TPN (preoperative bowel rest, treatment for comorbid severe malnutriton in clients with non functional GI tracts, Severely catabolic clients when GI tract nonusable for more than 4-5 days |
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What must occur before client receives the first enteral feeding?
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Verification of tube placement by x-ray examination needs to occur first.
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What are the 4 types of enteral formula?
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Polymeric formula, Modular formula, elemental formulas, and specialty formulas.
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Polymeric formula
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1-2 kcal/ml include milk-based blenderized foods.
In order for this formula to work, the patients GI tract has to be able to absorb whole nutrients. |
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Modular Formula
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-3.8-4 kcal/ml
-Single macronutrient (glucose, protiens, lipids) -Added to other foods for meeting client's nutritional needs |
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Elemental Formulas
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1.0-3.0 kcal/ml
-contain predigested nutrients that are easier for a PARTIALLY DYSFUNCTIONAL GI TRACT to absorb. |
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Specialty Formulas
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1-2 kcal/ml
-Designed to meet specific nutritional needs in certain illness (e.g. liver failure, pulmonary disease, or HIV infection) |
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How are feeding tubes typically started?
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Typically started at full strength at slow rates
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How often should you increase the hourly rate of feeding tubes?
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every 8-12 hrs. If no sighs of intolerance appear. (high gastric residuals, nausea, cramping and vomiting, an diarrhea)
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What are the benefits of feeding by ENTERAL route?
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It reduces sepsis, minimizes hypermetabolic response to trauma, maintains intestinal structures and function
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When is enteral nutrition successful?
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within 24 - 48 hrs after surgery or trauma to provide fluids, electrolytes, and nutritional support.
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How does naso-intestinal or jejunal tubes allow successful post pyloric feeding?
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because formula is placed directly into the small intestine or jejunum or beyond the pyloric sphincter of the stomach.
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What serious complication is associated with enteral feedings?
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ASPIRATION of formula into the tracheobronchial tree.
Aspiration of enteral formula into the lungs irritates the bronchial mucosa--> decrease blood supply to affected pulmonary tissue--> necrotizing infection, pneumonia, and potential abscess formation |
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How does high glucose content of feeding promote infection?
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High glucose serves as a bacterial medium for growth, promoting infection.
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What conditions are associated with pulmonary aspiration?
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Acute respiratory distress syndrome (ARSD)
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What common conditions increase the risk of aspiration?
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coughing, nasotracheal sunctioning, artificial airway, decreased level of consciousness, and lying flat.
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What medications promote gastric emptying and decrease the risk of aspiration?
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Prokinetic medications (metoclopramide, erythromycin, or cisapride)
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