ENT Nutrition

Question 1

What is Ent Nutrition?

Answer 1

Tube feeding, which is a method of delivering food to the body through the GI tract.

Question 2

What are different types of tubes?

Answer 2

-Naso-Gastric (NG) Tube
-Percutaneous Endoscopic Gastrostomy (PEG) Tube
-Gastrostomy Button (G-Button)

Question 3

Enteral Tube Indications

Answer 3

Cancer, Critical illness or trauma, Neurological or muscular disorders, GI Disorders, Respiratory failure with prolonged intubation, Inadequate oral intake.

Question 4

Enteral Tube Indication-Cancer

Answer 4

Head and neck, upper GI, radiation

Question 5

Enteral Tube Indication- Neurological or muscular disorders

Answer 5

Cerebrovascular accident, dementia, Parkinson’s

Question 6

Enteral Tube Indication- GI disorders

Answer 6

Fistula, inflammatory bowel disease, pancreatitis

Question 7

Enteral Tube Indications- Inadequate oral intake

Answer 7

Anorexia, dysphagia, severe depression

Question 8

Enteral Tube Assessment

Answer 8

GI System-
Appearance of abdomen, bowel sounds, palpation, elimination patterns.

Enteral Tube-
Location, length, insertion site, patency

Question 9

Enteral Nutrition- Closed system

Answer 9

Most common, System cannot be opened, can safely hang for 24 to 36 hours.

Question 10

Enteral Nutrition- Open system

Answer 10

Prepared by nurse at the bedside, solution(s) added to empty system container.

Question 11

4 types of enteral nutrition

Answer 11

-Continuous
-Cyclic
-Intermittent
-Bolus

Question 12

Continuous Nutrition

Answer 12

-Administer over 24-hour period using pump

-Initiate at low rate and increase rate every 8-12 hours until goal rate achieved or patient intolerance

-HOB 30 degree or greater at all times

Question 13

Cyclic Nutrition

Answer 13

-Administer under 24 hour period using pump often over night

-Patient may eat during break periods (check diet orders for restrictions)

-HOB elevated 30 degree or greater during feed administration and for minimum of 1 hour after stop

-Pre and post-flush with 30mL sterile water

Question 14

Intermittent Nutrition

Answer 14

-Initiate at specified volume, and increase volume every 8-12 hours until goal volume or patient intolerance

-Administered over at least 20-30 minutes by pump or gravity

-HOB elevated 30 degree for 1 hour minimum after each feed

-Pre and post-flush with 30 mL of sterile water

Question 15

Bolus Nutrition

Answer 15

-Administer Gravity

-Administer more quickly than intermittent feeding

-HOB elevated 30 degree or greater for 1 hour minimum after feed

-Pre and post-flush with 30mL of sterile water

Question 16

ET Feeding Complications

Answer 16

-Pulmonary aspiration
-Diarrhea
-Constipation
-Nausea/vomiting, cramping
-Dehydration
-Tube occlusion
-Tube displacement

Question 17

ET Feeding Interventions

Answer 17

-Pulmonary aspiration: Verify tube placement, HOB 30-45 degree, reassess gag reflex

-Diarrhea: Consider lower, continuous rate, isotonic formula, change feed bag and tubing Q24hr and PRN

-Constipation: Consider higher fiber formula, give water during flushes, assess ambulation status

-Nausea/vomiting, cramping: Lower rate, HOB 45 degree, lactose free, room temperature formula stop feed if GI obstruction

-Dehydration: Lower rate, isotonic formula, Increase free water

-Tube occlusion- Thoroughly crush and mix meds and shake formula can

-Tube displacement: Replace, confirm placement and secure properly

Question 18

Pulmonary Aspiration

Answer 18

-Signs & Symptoms: Cough, Shortness of breath, Raspy Voice, Gurgling

-Intervention: If aspiration is suspected- stop the feeding, Elevate HOB at least 30-45 degrees, notify physician, check placement

Question 19

What tools and techniques are used in placement verification?

Answer 19

-Gastric content pH test
-X-ray
-Tuber measurement