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35 Cards in this Set

  • Front
  • Back
Delivery of formulated enteral or parenteral nutrients to maintain or restore nutritional status
Nutrition Support
When should nutrition support be considered?
when a patient is unable to meet nutrition needs for more than a few days
Provision of nutrients into the GI tract through a tube or catheter; may include oral supplements or meal replacements like Ensure/Boost
Enteral Nutrition
What is parenteral nutrition?
provision of nutrients intravenously (through the veins)
Nutrition support include which of the following?

A) enteral nutrition
B) parenteral nutrition
C) both enteral and parenteral nutrition
D) none of the following
C. both enteral and parenteral nutrition
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
All of the above
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
D) all of the above
What are the benefits of enteral nutrition vs. parenteral nutrition?
-Better GI barrier function
-Preserved immunity
-Attenuate catabolic response
-Better blood glucose control
-Decreased rate of infection
What are conditions that often require enteral nutrition?
-Impaired nutrient ingestion
-Inability to consume adequate nutrition orally
-Impaired digestion, absorption, metabolism
-Severe wasting or depressed growth
What is enteral nutrition access?
the location of nutrient administration and type of enteral access device
Enteral nutrition access depends on what?
-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
List some examples of enteral nutrition access.
-Nasogastric route
-Nasoduodenal or nasojejunal route
-Percutaneous Endoscopic Gastrostomy (PEG)
-Laparoscopic/Fluroscopic techniques
-Surgically placed enterostomies (Gastrostomies and Jejunostomies)
-Multiple Lumen Tubes
Difference between closed enteral system and open enteral system.
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)
Which enteral system has a higher risk for contamination?

A) hang time
B) closed enteral system
C) open enteral system
D) enteral nutrition access
C. open enteral system
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
Hang time
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
D. both b and c
Which enteral nutrition route is most commonly used?

A) nasduodenal route
B) PEG tube
C) nasojejunal
D) nasogastric route
D. nasogastric route
This enteral route consist of going through the nose then into the stomach

A) nasogastric route
B) nasoduodenal
C) PEG tube
D) gastrostomies
A. nasogastric route
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
D. PEG tube
Suitability of a feeding formula should be evaluated based on what?
-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
Name some types of formula composition used in enteral nutrition
-Standard polymeric formulas
-High-nitrogen formula
-Elemental or predigested
-Specialized or disease specific formulas
-Modular components
Combining separate nutrient sources or modifying existing formula

A) Standard formula
B) Modular components
C) Specialized/Disease Specific formula
D) Elemental/Predigested formula
B) modular components
Formula aimed at a specific disease associated formulas

A) Specialized/Disease Specific formula
B) Modular components
C) elemental/predigested formula
D) standard formula
A) specialized/disease specific formula
High-nitrogen formula are composed of __________ kcal from protein

A) 10-20%
B) 5-10%
C) 18-25%
D) 40-50%
C. 18-25%
What are some disease that may require a high-nitrogen formula?

A) burns, fistulas, sepsis, trauma
B) cancer
C) anorexia
D) congenital anomalies
A. burns, fistulas, sepsis, trauma
Concentrated Standard formulas are composed of _______ kcal/mL

A) 1-1.2
B) 3-5
C) 0.5-2
D) 1.5-2
D. 1.5-2kcal/mL
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
B. specialized/disease specific formula
Administration or method selection of the formula is based on what?
-Patient's clinical status
-Living situations
-Quality of life considerations
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
C. hang time

*hang time is the length of time an enteral nutrition formula is considered to be safe for adminstration to a patient
Up to 500mL rapid delivery via large-bore syringe (3-4 times daily)
start with 100-150mL and increase as tolerated, 20-60 minutes, (4-6 times a day) via gravity drip or syringe
intermittent drip
Administered via infusion pump

For those who do not tolerate bolus or intermittent
continuous drip
Complications of enteral nutrition
-access problems
-administration problems
-GI complications
-metabolic complications
Potential Complications of Nasal Tubes
-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
What should be monitored when a patient is receiving enteral nutrition?
-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)