Complex Exam 3 - acute nutritional support Flashcards
What should be done before an initial enteral feeding?
abdominal x-ray
How long should you listen to bowel sounds in each quadrant with enteral feedings?
1 full minute in each
How can the stability of an enteral feeding tube be assessed?
by looking at the marker outside of the tube
How long should glucose checks be done for enteral feedings?
for the first 24 hours
What should the head of the bed be raised to during feedings?
30-45
Should feedings be left on when the patient is supine?
NO
When should an enteral feeding tube be flushed?
- before and after feedings
- q 4-6 h
How can enteral feedings cause diarrhea?
incorrect concentration of feedings
How can diarrhea from enteral feedings be treated?
by increasing fiber and fluids
What can enteral tube displacement cause?
aspiration pneumonia
If a patient is experiencing aspiration pneumonia, what should be done?
- STOP feeding
- suction with patient on side
- provide O2
- auscultate breath sounds
- get a CXR
What VS increase should be monitored with aspiration pneumonia?
temperature
When should enteral tube patency be checked?
- q 4 h
- before and after feedings
How often should enteral tube placement be checked?
q shift
How can you tell if the enteral tube is in the stomach (gastrostomy)?
pH <4
How can you tell if the enteral tube is in the jejunum (jejunostomy)?
pH >6
What is parenteral nutrition composed of?
- amino acids (protein)
- dextrose
- electrolytes
- minerals
- vitamins
- possibly fat emulsions
How is parenteral nutrition administered?
via infusion pump
What must be present in the tubing to collect particles from the parenteral solution?
a filter
What should be used if TPN runs out since it can never stop abruptly?
dextrose 10% in water
If on TPN feedings, how are labs drawn and fluids given?
with another IV site
What metabolic complications are TPN patients at risk for?
- hyper/hypoglycemia
- vitamin deficiencies
When does an air embolism occur?
during tubing changes
What should be done for air embolism?
- prime tubing
- clamp catheter
- lay on left side in trendelenburg
- admin O2
What can cause infection with parenteral feedings?
bacterial growth from concentrated glucose
How often should a CVL dressing be changed?
q 48-72 hours
How often should parenteral tubing be changed?
q 24 hours
