Chapter 12: Food and Nutrient Delivery: Nutrition Support Methods

Question 1

enteral nutrition (EN)

Answer 1

Nutrition provided through the gastrointestinal tract (GIT) via a catheter or a tube or stoma that delivers nutrients distal to the oral cavity

Question 2

parenteral nutrition (PN)

Answer 2

The provision of nutrients intravenously

Question 3

sentinel events

Answer 3

Undesirable outcomes such as unexpected death, serious physical injury with loss of limb or function, or psychological injury

Question 4

computerized provider order entry (CPOE)

Answer 4

A system that allows prescribers to enter an order directly into a computer, often aided by decision-support technology to help facilitate accuracy and clinical effectiveness

Question 5

French size

Answer 5

The measure of the outer tube diameter. One French unit is 0.33 mm

Question 6

nasogastric tube (NGT)

Answer 6

Used most commonly to access the GIT, for gastric decompression, medication delivery, and/of feeding. Only appropriate for short time periods

Question 7

nasoduodenal tube (NDT)

Answer 7

A tube that terminates in the duodenum.

Question 8

nasojejunal tube (NJT)

Answer 8

A tube that terminates in the jejunum

Question 9

percutaneous endoscopic gastronomy (PEG)

Answer 9

A nonsurgical technique for placing a tube directly into the stomach through the abdominal wall. PEG refers to the procedure, not the tube

Question 10

percutaneous endoscopic jejunostomy (PEJ)

Answer 10

A nonsurgical technique for placing a tube directly into the jejunum through the abdominal wall

Question 11

gastrojejunostomy

Answer 11

A surgical procedure in which an anastomosis is created between the stomach and the proximal loop of the jejunum

Question 12

gastrointestinal decompression

Answer 12

Removal of the contents of the stomach through a nasogastric tube

Question 13

multiple lumen tube

Answer 13

Includes one lumen for decompression and one for feeding into the small bowel

Question 14

osmalality

Answer 14

The concentration of a solution expressed as the total number of solute particles per kilogram

Question 15

polymeric enteral formula

Answer 15

Enteral formulas that contain intact macronutrients, are lactose free, and frequently may be used as an oral supplement as well as an enteral feeding

Question 16

closed enteral system

Answer 16

The container or bag is prefilled with sterile liquid formula by the manufacturer and is “ready to feed” after connecting to the patient’s feeding access

Question 17

open enteral system

Answer 17

The contents of the formula cans or packages are poured into a separate empty container or bag and then connected to the feeding access

Question 18

hang time

Answer 18

The length of time an enteral formula hanging at room temperature is considered safe for delivery to the patient

Question 19

bolus enteral feedings

Answer 19

Administered over 5 to 20 minutes, these feedings are more convenient and less expensive than pump or gravity bolus feedings and should be encouraged when tolerated

Question 20

intermittent enteral feedings

Answer 20

Cyclic regimens allow mobile patients an improved quality of life by offering time “off the pump” and more autonomy. Intermittent feedings can be given by pump or by gravity drip.

Question 21

gastric residual volumes (GRV)

Answer 21

The amount of liquid drained from a stomach following administration of enteral feed. Significant disagreement exists about using GRV as an indicator of EN tolerance

Question 22

central parenteral nutrition (CPN)

Answer 22

Central access refers to catheter tip placement in a large, high-blood-flow vein such as the superior vena cava

Question 23

peripheral parenteral nutrition (PPN)

Answer 23

Refers to catheter tip placement in a small vein, typically in the hand or forearm

Question 24

osmolarity

Answer 24

The concentration of a solution expressed as the total number of solute particles per liter

Question 25

peripherally inserted central catheter (PICC)

Answer 25

May be used for short- or moderate-term infusion in the hospital or in the home. This catheter is inserted into a vein in the antecubital area of the arm and threaded into the subclavian vein with the catheter tip placed in the superior vena cava

Question 26

intravenous lipid emulsions (ILE)

Answer 26

Provide calories and the essential fatty acids (EFA), linoleic acid (LA) and alpha-linoleic acid (ALA) in PN to avoid EFAD

Question 27

home parenteral nutrition (HPN)

Answer 27

PN received at home. Most often is infused during 10 to 12 hours per day with the lipid as part of the PN solution.

Question 28

total nutrient mixture aka 3-in-1 solution

Answer 28

Parenteral nutrition method that combines the lipid emulsion with dextrose and amino acid solution

Question 29

rebound hypoglycemia

Answer 29

Low blood sugar levels resulting from abrupt cessation of parenteral nutrition

Question 30

hemodynamic stability

Answer 30

Maintenance of adequate blood pressure

Question 31

refeeding syndrome

Answer 31

Can lead to severe, potentially lethal electrolyte fluctuations involving metabolic, hemodynamic, and neuromuscular problems. Refeeding syndrome occurs when energy substrates, particularly carbohydrate, are introduced into the plasma of anabolic patients

Question 32

transitional feeding

Answer 32

Moving from one type of feeding to another, with several feeding methods used simultaneously while continuously administering estimated nutrient requirements

Question 33

home enteral nutrition (HEN)

Answer 33

Enteral nutrition received at home

Question 34

advance directives

Answer 34

Legal documents that state patient preferences about aspects of care, including those regarding the use of nutrition support

Question 35

durable medical equipment (DME) provider

Answer 35

Providers who may provide clinical services