Adult Nutrition

Question 1

MUST Scores

Answer 1

0- low risk

1- medium risk (observe)

2- high risk (treat)

Question 2

Enteric Feeding Methods

Answer 2

NG- short term use

NJ- gastric reflux or delayed gastric emptying

PEG/J- longer term feeding/ mechanical swallowing obstruction

• endoscopically
• radiographically: if patient cannot swallow

Question 3

Feeding regimens

Answer 3

Boluses- more physiological but can cause dumping syndrome

Intermittent infusion- most commonly used

Continuous infusion- very ill patients

Question 4

Giving drugs via enteric tubes

Answer 4

Use solutions where possible

Some tablets can be crushed and some capsules can be opened (check with pharmacist)

Tablets you can’t crush- MR tablets, enteric coated tablets

Question 5

Parenteral nutrition

Answer 5

Maybe required in intestinal failure (acute/chronic)

Given by a central venous line

Question 6

Referring Syndrome

Answer 6

Feeding malnourished patients can cause a surge on insulin and activation of cellular membrane pumps- drops serum electrolyte levels and can cause death (arrhythmia)

Question 7

Risk factors for re-feeding syndrome

Answer 7

Weight loss >15% over 3-6 months, poor intake for >10 days, low electrolytes, alcohol excess

Question 8

Management of re-feeding syndrome

Answer 8

10 calories/kg/day and build up gradually
Check K/phosphate/magnesium at least once daily
Give supliments- pabrinex/electrolytes as required