EN Flashcards

1
Q

Indications for EN

A

inadequate or expected inadequate oral intake 7-14 days

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2
Q

Contraindications

A

obstruction, severe GIB, GI malabsorption, EN failed, no GI access

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3
Q

Critically ill when to start EN

A

24-48 hrs

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4
Q

Water in Standard formula

A

82-85%/liter

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5
Q

Water in 1.5 cal/cc formula

A

76-78%/L

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6
Q

Water in 2 cal/cc formula

A

70%/L

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7
Q

Tap water for flushes?

A

Adequate for healthy populations, but nosocomial infections in critically ill or immune compromised

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8
Q

Soluble Fiber

A

inc Na and water absorption

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9
Q

Insoluble Fiber

A

Dec transit time by inc fecal weight

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10
Q

Immune enhancing formula

A

beneficial with major surgery vs. critical illness=ASPEN dec vent, dec infection, dec LOS but no overall impact on mortality

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11
Q

Hang time OPEN SYSTEM

A

8 hrs

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12
Q

Hang time CLOSED SYSTEM

A

24-48 hrs

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13
Q

Hang time RECONSTITUTED

A

4 hours

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14
Q

What slows gastric emptying

A

opiates/meds, dec BP, sepsis, anesthesia, autoimmune dz, rapid TF rate, cold sol’n, inc fat sol’n

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15
Q

What meds can aid slow gastric emptying

A

prokinetic agent, anit-emetics

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16
Q

Contraindications EN-GI related

A

Intractable N/V, Severe short gut, ileus, distal high output fistula

17
Q

severe short bowel is how much sm bowel remaining

A

less 100cm

18
Q

Contraindications to EN- nourished status

A

malnourished <5-7 days, 7-9 days for nourished pts

19
Q

Secretory Diarrhea causes dz related

A

IBS, intestinal resection, bile/fatty acid malabsorption, celiac sprue, sm int lymphoma, villous adenoma rectum, Zollinger-Ellison syndrome

20
Q

Secretory Diarrhea-infectious/med related

A

C.Diff, laxative abuse, chronic infections

21
Q

Meds that increase diarrhea

A

digoxin, Mag containing, metoclopramide (reglan), neomycin, theophylline

22
Q

Treat Diarrhea with TF Tx such as

A

continuous infusion, feed into duodenum, dec rate

23
Q

Systemic hypotensive status- avoid what TF

A

fiber

24
Q

Who is at risk for aspiration

A

hx aspiration, neuro dz, ETT, vomit, high residuals, supine, ABD/THORACIC SURGERY

25
Q

HOw much average gastric residuals/day

A

2-3 liters

26
Q

Add promotility agent when residuals are

A

over 250cc x 2

27
Q

Hold TF and reassess when residuals are

A

over 500cc, consistently over 500—post pyloric tube

28
Q

Refeeding, start TF to meet what % nutrient needs

A

25% goal, adv 3-5 days

29
Q

Transition protocol: PN to TF

A

Dec PN once tolerates 33-50% TF, d/c PN once tol 50-75% TF

30
Q

Transition protocol: TF to Po

A

Cal count, night cycle or bolus feeds, D/C TF if po greater 75%

31
Q

Osmotic Diarrhea

A

Lactose malabsorption, Tf cause, inc SCFA