Chapter 13 Nutrition Support

Question 1

What is one reason EN is better than PN

Answer 1

reduces risk of bacterial translocation

Question 2

Another reason EN better than PN

Answer 2

lower infectious complications, pneumonia, central line infections

Question 3

T/F all short term EN access require radiographic confirmation of catheter tip placement

Answer 3

T

Question 4

T/F NG and OG tubes require a pump

Answer 4

false

Question 5

hemodynamic instability

Answer 5

low blood pressure, high dose pressors, MAP <60-70)

Question 6

which chemo may increase fluid needs for EN

Answer 6

cisplatin

Question 7

avoid holding EN for GRV less than

Answer 7

500 mL (in absences of other intolerance signs)

Question 8

If GRV >250 two times what might we want to do

Answer 8

metoclopramide or erythromycin

Question 9

How to unclog feeding tube

Answer 9

5 mL warm water near clog for 1 minute, gentle push pull motion with syringe to help dislodge clog- then commerical declogging device

Question 10

For diarrhea once trialing other options what is last resort

Answer 10

elemental semi elemental formula, lower fat or higher MCT formula, add pancreatic enzymes

Question 11

PN indications

Answer 11

acute necrotizing pancreatitis (inability to tolerate EN), high output GI fistula (unless able to place distal to fistula)

Question 12

non tunneled catheter

Answer 12

PICC

Question 13

PPN requires concentration less than ___ mOsm.L

Answer 13

900

Question 14

dextrose

Answer 14

3.4 kcal/g <5 mg/kg/min

Question 15

lipids

Answer 15

10 kcal/g (20-30% kcal from fat) <60% of kcal

Question 16

AA

Answer 16

9 kcal/g <2.5 g/kg

Question 17

kcal needs for refeeding

Answer 17

15 kcal/kg or 2 mg/kg/min

Question 18

TPN fluid needs

Answer 18

30-40 mL/kg

Question 19

ALT, AST, ALP, T bili if high

Answer 19

cycle PN, decrease dextrose, <1 g/kg/d of fat

Question 20

if TG >____hold IVFE

Answer 20

400