ENTERAL Flashcards
Provision of liquid diets by mouth or by tube into the GIT
Enteral nutrition
Goal of enteral nutrition
To provide nutritional support for persons unable or unwilling to ingest or tolerate conventional foods
Indications of enteral nutrition
-Px who are physically or psychologically unable to take food by mouth in amounts sufficient to meet requirements
-Px who are able to consume some, but not enough food to meet requirements
-Px with full / partial GIT function
-Medical conditions that makes oral intake compromise or contraindicated for >5-7 days
Medical conditions indications of EN
Hypermetabolism - major surgery, sepsis, trauma, burns, organ transplant, HIV/AIDS
Neurological Diseases - stroke, motor neuron disease, multiple sclerosis, head injury, demyelinating diseases
GI Diseases - esophageal obstruction, inflammatory bowel syndrome, pancreatic insufficiency, cystic fibrosis, gastrectomy
Cancer - chemotherapy, radiotherapy or surgery
Psychiatric Diseases - anorexia nervosa, severe depression
Organ System Failure - respiratory, renal, cardiac or hepatic
Learning Disabilities - cerebral palsy, rett syndrome
Relative contraindications of EN
-Non-functional GIT
-GIT function cannot be fully assessed
-Px whose nutritional needs cannot be met with oral diets or enteral tube feeding (terminal illness, short bowel syndrome/obstruction, GI bleeding, vomiting, diarrhea, GI fistulas, ischemia, ileus, inflammation, pancreatitis)
Indications of intact or polymeric formula
For px who are unable to digest & absorb nutrients w/o difficulty
Another term for intact or polymeric formula
meal replacement formula
types of intact or polymeric formula
-standard polymeric formula (lactose-free; low-osmolality)
-high-nitrogen polymeric formula (lactose-free; low to moderate osmolality; for px with CHON reqts)
-Fiber-containing formula (with fiber from natural food sources or from added soy polysaccharide; lactose-free; low-osmolality)
-blenderized formula (with lactose; very high viscosity; moderate osmolality; composed of a mixture of ordinary foods with oils + micronutrients as needed)
Indication of hydrolyzed formula
for px who are unable to digest certain nutrients or who have smaller than normal area for absorbing nutrients
Another term for hydrolyzed formula
pre-digested / monomeric / elemental
Characteristics of hydrolyzed formula
-hyperosmolar
-lactose-free
low fat & may contain BCAAs
-with unpleasant taste
-more expensive than intact formula
Indications of modular formula
for px who have specific metabolic or fluid imbalances that preclude the administration of a standard formula
Characteristics of modular formula
-made up of a single pre-digested nutrient (ex. CHO, CHON, Fat)
-may be added to another formula
-do not contain micronutrients & electrolytes
-may require micronutrient & electrolyte supplementation
Indications of specialty formula
for px who require different proportions or types of CHON, AA, Fat, CHO & electrolytes (ex. liver, renal, pulmonary diseases; diabetes)
Characteristics of specialty formula
-some are unpalatable
-most are very expensive
-may be produces from modular formulas
Description of nasogastric
-nose to stomach
-easy tube insertion
Indications of nasogastric
-intact gag reflex
-normal gastric emptying
-no esophageal reflux
-short term feeding
Risk of nasogastric
high risk of pulmonary aspiration
Description of nasoduodenal
nose to duodenum
indications of nasoduodenal
-impaired gastric emptying
-esophageal reflux
-potential GI intolerance
-short term feeding
risk of nasoduodenal
-reduced aspiration risk
-potential GIT intolerance
description of gastrostomy
tube inserted to the stomach (surgical or non-surgical; PEG)
indications of gastrostomy
-swallowing dysfunction
-long-term feeding
risk of gastrostomy
-potential risk of aspiration
-potential infection at stoma site
description of jejunostomy
tube inserted to the intestine (endoscopic / laparoscopic)
indications of jejunostomy
-esophageal reflux
-impaired gastric emptying
-long-term feeding
risk of jejunostomy
-potential risk of aspiration
-potential infection at stoma site
description of continuous
-pump-assisted
-small-bowel feedings
indications of continuous
critically ill
risk of continuous
less risk of gastric residuals & aspiration
description of intermittent
-pump assisted
-home tube feeding
-requires formula with more calories & CHON
-feeding over short period of time
indications of intermittent
non critically ill patient
risk of intermittent
-high risk of aspiration
-nausea, vomiting, abdominal pain, distention, diarrhea
-potential GI intolerance to target infusion rate
description of bolus intermittent
-via syringe or bulb
-home tube feeding
-feeding over short period of time (around 15 mins)
indications of bolus intermittent
non critically ill patient
risk of bolus intermittent
-highest risk of aspiration
-nausea, vomiting, abdominal pain, distention, diarrhea
-potential GI intolerance to target infusion rate
description of cyclic intermittent
-pump assisted
-home tube feeding
-used for transitioning tube to oral feeding
-requires formula with high calories & CHON
-requires high infusion rate over short period of time (8-16 hrs)
indications of cyclic intermittent
non critically ill patient
risk of cyclic intermittent
-potential GI intolerance to target infusion rate
Steps in the formulation of a food plan for blenderized feeding
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