Adult Enteral Nutrition Flashcards

1
Q

First rule to enteral nutrition=

A

If the gut works, USE IT!

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2
Q

Enteral nutrition benefits

A
  • Decrease in infectious complication and improved outcomes
  • Plays a role in maintaining gut mucosal growth and development to preserve gut function
  • Prevent stress related damage/ulcers
  • Fewer metabolic complications
  • reduced risk of developing cholestasis, gallbladder sludge and gallstones
  • Avoids complications with placement
  • Less costly
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3
Q

***Contraindication for Enteral nutrition

A
Mechanical obstruction
Diffuse peritonitis
Severe diarrhea
Severe GI hemorrhage
Intractable vomiting
Chronic intestinal pseudo-obstruction
Severe malabsorption
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4
Q

Functionality of the GI Tract

A

Got to have enough jejunum and ileum to absorb food
Decreased transit time due to removal of a valve
Reduced gastric emptying (risk of N/V and pulmonary aspiration)

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5
Q

Most common carbohydrate source is

A

corn syrup

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6
Q

Most common fat source is

A

Corn oil or palm kernel oil

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7
Q

Most common protein source is

A

Milk protein

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8
Q

Elemental is only used in those that:

A

have poor absorption

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9
Q

Partially hydrolyzed =

A

Rarely every used

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10
Q

Amino Acids that are not normally essential but in disease states they are:

A

Glutamine and arginine due to in high physiologic stress they become deficient

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11
Q

Glutamine function

A

Fuel for enterocyte

Helps maintain integrity of gut mucosa

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12
Q

Supplemental arginine does what:

A

Decrease protein catabolims
Enhance
nitrogen retention
Accelerate wound healing

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13
Q

Sufficient linoleic acid is required to

A

prevent essential fatty acid deficiency and should be 1-3% of daily total calories

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14
Q

Fiber functions

A

Decrease bacteria

Reduce incidence of diarrhea and helps keep the colon clean

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15
Q

Standard Polymeric:

A

Used 90% of the time
Jevity is most common
1-1.2 kcal/mL
Typically have to add water

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16
Q

High protein use

A

> 1.5 g/kg/day requirement

Trauma pts with burns, pressure sores, or wounds

17
Q

High caloric density use

A

Typically in fluid restricted pts

18
Q

Elemental and peptide based use

A

Pts who have absorption problems: short bowel, colon removed

19
Q

Pulmonary and diabetic use

A

Low carbs

20
Q

EN Regimen Considerations

A
  • Evaluate risk of aspiration
  • Flush feeding tube with at least 30 mL of sterile water every 4 hours during continuous feeding
  • Schedules of progression and advancement should be individualized
  • Do not dilute formulas bit add free water as boluses intermittently
  • If GRV is >250 mL after second residual check, add a promotility agent
  • GRV > 500 mLshould result in holding EN and evaluate tolerance
21
Q

Electrolytes, BUN/SCr, glucose monitoring

A

Daily during initiation

Every 1-3 months during stable

22
Q

Ca, Mg, P monitoring

A

3-7 per week during initiation

Every 1-3 months during stable

23
Q

Liver function test monitoring

A

Weekly during initiation

Every 1-3 months during stable

24
Q

Trace elements and vitamins monitoring

A

If deficiency or toxicity is suspected