Ch 45: Nutrition Flashcards
What is EN and when is it used?
- Enteral Nutrition
- Provides nutrients via the GI tract for PTs dysphasia (inability to swallow) or NPO
What is PN and when is it used?
- Parenteral Nutrition
- Nutrition given via IV
What are the two types of PN administration?
- PPN
- TPN
What is TPN and the characteristics to keep in mind with it?
- Total Parenteral Nutrition
- Given to PT that can’t tolerate oral or enteral methods
- Higher concentration of nutrients (proteins and sugars)
- Administered through a central line – via jugular or subclavian to superior vena cava
- Long term
- Watch line for infection at insertion point
What is PPN and the characteristics to keep in mind with it?
- Partial Parenteral Nutrition
- Given to those who can tolerate a little oral food, but don’t get enough nutrients - supplementary
- Administered through peripheral vein
Gastric Residual refers to…
the volume of fluid remianing in stomach at a point in time during EN feeding.
Gastric residual is the difference between
the feeding amount supplied and gastric emptying rate
Gastric residual can effect what two main things?
- pH
- Nutrient absorption
What are signs of a good EN feeding rate?
- Abscence of Nausea, Diarrhea
- Low gastric residual
A high gastric residual rate can lead to _____.
Aspiration
How is a high gastic residual rate assessed?
- 2 measurements of >250mL one hour apart OR
- 1 measurement of >500mL
What should you do if a high gastric residual rate is indicated?
- Stop feed
- Let residual return to normal level
- Notify MD
A gastic residual of <250 indicates
no problem.
What is the difference between a PIC line and a Central Line?
nothing
Possible EN complications
“PATCHED”
- Pulmonary aspiration
- Abdominal cramping, nausea/vomiting
- Tube occlusion or displacement
- Constipation, diarrhea
- Hyperosmolar dehydration
- Electrolyte imbalance/fluid overload
- Delayed gastric emptying
Possible PN complications
Fonzie says “EHHHH”
- Electrolyte imbalance
- Hypercapnia
- Hyperglycemic hyper-osmolar nonketotitc dehydration/coma (HHNC)
- Hyperglycemia
- Hypoglycemia
NG tube
How is it applied?
- Tip of nose
- Behind earlobe
- Xyphoid process (of sternum)
- Secure w/ tape on face
What must happen after a NG tube is inserted?
- Get an x-ray to ensure tube is in stomach, not lungs
What is the secondary check after a NG tube is inserted?
Aspirate to check pH
When do we flush a PEG feeding tube?
Before and after feeding
What does PEG stand for?
Percutaneous Endoscopic Gastrostomy
True or False
Nutrients delivered via EN/PN/PEG are allowed to free flow.
- False, a pump must be used to regulate flow rate
What are the essential nutrients?
- H2O
- Macronutrients
- Micronutrients
What are Macronutrients used for?
- Energy sources
- Build tissues
What are Micronutrients used for?
- Regulate body processes
What are the three macronutrients?
- Carbohydrates
- Proteins
- Lipids
What are the two micronutrients?
- Vitamins
- Minerals
How many kcals are there per gram for:
Carbs
Proteins
Alcohol
Lipids
- Carbs (CH2O) = 4 cals
- Proteins = 4 cals
- Alcohol = 7 cals
- Lipids = 9 cals
120 grams of proteins provides how many kcals?
120*4 = 480 kcal
30 Grams of Carbs (CH2) = how many kcals?
30*4 = 120 kcals
70g of ETOH (alcohol) provides how many calories?
70*7 = 490 kcal
60g of fat provides how many calories?
60*9 = 540 calories
Daily diet should consist of how many calories?
2,000
How much of the following should be eaten per day?
Fruits
Veggies
Milk
Meat/beans
Grains
- Fruits = 2 cups
- Veggies = 2.5 cups
- Milk = 3 cups
- Meat/beans = 5.5 oz
- Grains = 6oz
HDL
What does it stand for?
What is it?
What does it do?
What is its level?
- HDL stands for High Density Lipoprotein
- HDL is good cholesterol
- It carries cholesterol to liver to be excreted
- A level >60mg is good
LDL
What does it stand for?
What is it?
What does it do?
What is its level?
- LDL stands for Low Density Lipoprotein
- It is bad cholesterol
- LDL keeps cholesterol in blood which can lead to atherosclerosis
- A level of > 130 is bad
What vitamins are water soluble?
B and C
What vitamins are fat soluble?
A, D, E, K
How many kcals are there per gram for:
Carbs
Proteins
Alcohol
Lipids
- Carbs (CH2O) = 4 cals
- Proteins = 4 cals
- Alcohol = 7 cals
- Lipids = 9 cals
120 grams of proteins provides how many kcals?
120*4 = 480 kcal
30 Grams of Carbs (CH2) = how many kcals?
30*4 = 120 kcals
70g of ETOH (alcohol) provides how many calories?
70*7 = 490 kcal
60g of fat provides how many calories?
60*9 = 540 calories
Daily diet should consist of how many calories?
2,000
How much of the following should be eaten per day?
Fruits
Veggies
Milk
Meat/beans
Grains
- Fruits = 2 cups
- Veggies = 2.5 cups
- Milk = 3 cups
- Meat/beans = 5.5 oz
- Grains = 6oz
What percentage of the diet should come from Protein?
25-35%
What percentage of the diet should come from Carbs?
45-65%
What percentage of the diet should come from fats?
25-35%
How many much of our total calories should come from saturated fat?
<10%
