ENTERAL AND PARENTERAL NUTRITION Flashcards
through the gastrointestinal system
enteral
through intravenous methods
parenteral
also known as tube feeding, is a
way of delivering nutrition
directly to your gastrointestinal
(GI) tract or small intestine
usually from a tube, catheter,
or stoma
enteral nutrition (EN)
uses of a feeding tube
- provide nutrition
- provide fluids
- provide medication
- decompressing the stomach
- removing stomach contents
types of tubes for enteral feeding
- nasogastric tube
- nasoenteric tube
- gastrostomy tube
- jejunostomy tube
- starts in the nose and ends in the stomach
- used for feeding clients who have adequate gastric emptying, and who require shorter-term feedings
nasogastric
- starts in the nose and ends in the intestines
- indicated for use in enteral nutrition in both gastric and small
intestine regions, such as the duodenum and jejunum. They
are ideal for short‐term feeding, especially patients at risk for
aspiration, reflux, and gastric emptying delay
nasoenteric
2 sub types of nasoenteric
nasoduodenal
nasojejunal
starts in the mouth and ends in the stomach
orogastric
starts in the mouth and ends in the intestines
oroenteric
- feeding tube inserted through a surgical opening in the neck and passed through the esophagus, with the tip resting in the stomach
- used for patients with head and neck cancer
esophagostomy
- placed through the skin of the abdomen straight to the stomach
- used when a patient cannot
or will not eat for longer than
four weeks and has a
functional gut
gastrostomy tube
subtypes of gastrostomy tube
PEG, button tubes
- placed through the skin of the abdomen straight into the jejunum intestines
- are useful for patients with contraindications to gastrostomy
jejunostomy tube
subtypes of jejunostomy tube
PEJ, PRJ tubes
is the most common complication of tube feeding usually caused by protein-energy malnutrition, medications, motility, infection, impaction, infusion rate, osmolality and bacterial contamination of formula
diarrhea
the most dangerous complication of enteral feeding and is among the leading causes of death in tube-fed patients
aspiration of formula
common metabolic complications
electrolyte imbalance, hyperglycemia, refeeding syndrome
also called “standard” or “polymeric” formulas and contains
unaltered molecules of protein, carbohydrates and fat.
intact formulas
are predigested micronutrients. They are either elemental
or semi-elemental formulas
hydrolyzed formulas
are individually packaged components that may be
combined to meet the nutritional
requirement of the patients
modular formulas
are formulas that have been
altered in one or more nutrients in order to optimize nutrition support without exacerbating the metabolic disturbances associated with various diseases
nutrient modified and disease specific formulas
- the most commonly used method of enteral feeding; often referred to
as a “kangaroo pump” - indicated for patients who
are unable to tolerate high volume feedings
continuous method
- solution is infused at a constant
rate controlled by a pump - administered over at least 30 min.;
continuous rate over a 16 to 24-
hour pd
continuous method
- continuous drip method over a period of 8-20 hours per day using a pump to control delivery
- usually given at night; allowing
independence from feeding equipment during the day - may be used when feeding into the stomach or small intestine
cyclic feeding
- usually requires a higher
infusion rate which requires closer monitoring for formula and delivery tolerance - usually well-tolerated and effective for malnourished patients especially for the ambulatory elderly population
cyclic feeding
allow for more mobility
than continuous drip feedings because there are breaks in the feedings, allowing the patient to be free from the tube feeding apparatus or activities such as physical therapy
bolus feeding
closely mimics usual eating pattern and involves shorter period of infusion at specified intervals – usually four to six times a day.
bolus feeding
characterized by rapid administration of the formula
usually less than 15 minutes into the GI tract by syringe or feeding bag
bolus feeding
uses a similar technique to that of bolus feeding, but it is used over a
longer duration, which may help
improve tolerance
intermittent delivery
- use an open-top container or syringe
- provided in flip-top cans powdered formula or blenderized formula
open system
formula left over from open system delivery should be discarded after?
8-12 hours OR 24 hours
consists of pre-filled container
that is spiked with enteral
tubing & attached to enteral
access device
closed system
viability of closed system feeding formulas
48 hours
what do you do to prevent clogging of tube?
flush tube with 5-10 cc of water before and after administration
provided when the
gastrointestinal tract is
nonfunctional because of
an interruption in its
continuity or because its
absorptive capacities is
impaired
parenteral nutrition
TPN
CVN
IVH
total parenteral nutrition
central venous nutrition
intravenous hyperalimentation
TPN solutions are ___,
they are injected only into
high-flow central veins, where
they are diluted by the client’s
blood
hypertonic
When TPN therapy is to be
discontinued, the TPN infusion rates are decreased slowly to prevent ___
hyperinsulinemia
hypoglycemia
weaning of TPN may take up to ___ hours
48
