13 - Oral, Enteral, & Parenteral Nutrition Flashcards
What is malnutrition?
Deficiency or excess (or imbalance) of energy, protein, and other nutrients
What is cachexia?
General weight loss and wasting occurring in the course of a chronic or emotional disease
What are nutrition supplements?
Vitamins, minerals, herbs, meal supplements, sports nutrition products, natural food supplements, and other related products used to boost the nutritional content of the diet
What is nutrition support?
Provision of enteral or parenteral nutrients to treat or prevent malnutrition
What is enteral nutrition?
Feeding tube is placed in GI tract to deliver liquid formulas containing all essential nutrients
What is parenteral nutrition?
Infusion of complete nutrient solutions into the bloodstream (via central or peripheral vein)
What are some complications of malnutrition?
- Impaired immune responses
- Reduced muscle strength and fatigue
- Reduced respiratory muscle function (increasing risk of chest infection and respiratory failure)
- Impaired thermoregulation
- Impaired wound healing and delayed recovery from illness
- Apathy, depression, self-neglect
- Increased risk of admission to hospital and length of stay
What are some nutrition assessment tools?
- Malnutrition screening tool
- Malnutrition screening tool for cognitively impaired
- Nutrition risk assignment for frail elderly
- Mini nutrition assessment
- Subjective global assessment
What nutrition screening questions should be asked at admission?
1) Have you lost weight in the past 6 months without trying?
2) Have you been eating less than usual for more than a week?
Who are nutritionally high risk patients?
- Diagnosis of malnutrition
- Evidence of significant weight of 5% in 1 month, 7.5% in 3 months, or 10% in 6 months
- Diagnosis or conditions requiring increased calories and protein
- Low body weight (BMI less than 18.5)
- Oral dietary intake less than 50% of estimated energy needs for 3 or more days
- Poor acceptance of traditional oral nutritional supplement given during or btwn mealtimes
How often and when should high energy/protein shakes/drinks be taken?
Ideally 2 bottles per day between meals (not to replace meals)
What are potential indications for oral nutrition supplements?
- BMI under 18.5
- Unintentional weight more than 10%
- Eating less or nothing for more than 5 days
- Poor absorptive capacity
What are potential indications for enteral nutrition?
- When oral intake inadequate or not recommended for a prolonged period of time
- When GI tract is functioning
What are benefits of enteral over parenteral nutrition?
- Greater convenience
- Lower cost
- Decreased infectious complications
- May enhance immune function, maintain gut flora/integrity
- Decrease metabolic complications
- Allow access for medication administration
What are some tips for medication administration w/ enteral feeding?
- Consider tube size (risk of clogging) and placement site (site of drug absorption)
- Use liquid dosage form when possible (elixirs and suspensions over syrups)
- Dilute hypertonic medications w/ 10-30 mL of water
- Crush tablets to fine powder and mix w/ 30 mL water
- Administer each drug separately
- Flush tube w/ 15-30 mL warm water before giving drug, w/ 5-10 mL warm water btwn each drug, and 15-30 mL water after last medication given
