artificial feeding

Question 1

what is enteral nutrition ?

Answer 1

delivery of food through a tube ayan kan el tube

Question 2

why is enteral nutrition preferred over parenteral nutrition ?

Answer 2

in order to preserve the functional integrity of the gut

Question 3

when is enteral feeding indicated ?

Answer 3

when swallowing or food ingestion is impaired but intestinal function is intact

1- stroke - inability to study
2- oral intubation for mechanical ventilation
3- to bypass obstruction or high output fistula

Question 4

what are the different methods of enteral feeding ?

Answer 4

nasogastric tube
gastrostomy
jejunostomy

Question 5

when is gastrostomy indicated ?

Answer 5

when enteral feeding will be needed for more than 4 weeks

Question 6

what are the. advantages of enteral nutrition vs parenteral nutrition ?

Answer 6

fewer episodes of infection
reduced cost
reduced hospital stay
earlier return to intestinal function

Question 7

what are the contraindications for EN ?

Answer 7

severe short bowel syndrome
sever malabsorptive disease
severe GI bleed
paralytic ileus
intractable diarrhea or refractory vomiting
inoperable mechanical obstruction
distal high output fistula

Question 8

what are the complications of EN ?

Answer 8

1- tube misplacement
2- reflux of gastric contents - pulmonary aspiration
3- interrupted feeding and inadequate feed volumes
4- refeeding syndrome

Question 9

what are the complications of gastrostomy ?

Answer 9

1- reflux - pulmonary aspiration
2- risk of insertion
3- risk of tumor seeding
4- refeeding syndrome

Question 10

what are the two types of parenteral nutrition ?

Answer 10

TPN - total parenteral nutrition ( all dietary needs need to be replaced)
PPN - partial parenteral nutrition (supplementary nutrition)

Question 11

what is the clinical picture of refeeding syndrome ?

Answer 11

nausea, vomiting, muscle weakness, seizures, respiratory depression, cardiac arrest and sudden death

Question 12

what patients are at a higher risk of refeeding syndrome ?

Answer 12

chronic alcoholics

Question 13

how can refeeding syndrome be prevented ?

Answer 13

gradual increase in the caloric intake in malnourished patients

Question 14

what type of EN in short term feeding ?

Answer 14

nasogastric feeding tube

Question 14

what must bee done to ensure proper tube positioning before starting tube feed ?

Answer 14

chest x ray

Question 14

what is parenteral feeding ?

Answer 14

large diameter vein is used to deliver nutrition, completely bypassing the gut and portal venous system

Question 14

how is the decision on whether to use a central or peripheral route for PN made ?

Answer 14

depends on the formula osmolarity and infusion rate :
peripheral PN : for short term ( less than 2 wks)
central PN : periods longer than 2 weeks

Question 15

when should parenteral nutrition be considered ?

Answer 15

patient unable to fulfill their requirements with EN
Failure of EN administration
contraindication to EN

Question 15

long term feeding ?

Answer 15

gastrostomy

Question 15

what are the complications associated with PN ?

Answer 15

mainly infective and metabolic disturbances