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Nutrition > Enteral and Parenteral Nutrition > Flashcards

Enteral and Parenteral Nutrition Flashcards

1
Q

What is the definition of malnutrition?

A

The deficiency or excess or imbalance of energy, protein and other nutrients

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2
Q

What are the 4 categories of malnutrition?

A

Under-nutrition resulting from insufficient food intake
Over-nutrition caused by excessive food intake
Specific nutrient efficiencies
Imbalance due to disproportionate food intake

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3
Q

What are the 4 basic questions to early identification of malnutrition?

A

Have you lost weight?
If yes, how much weight have you lost and over what time frame
What is your current weight?
What is your current height?

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4
Q

What is the main cause of malnutrition in hospital? What leads to this cause?

A

Disease

Pro-inflamm effect of illness is the culprit

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5
Q

What are the indications for oral nutrition?

A

Consistent with medical and patient’s goal
Inadequate or oral intake to meet nutrient needs
Func GI tract
Safe func swallow

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6
Q

What are the indications for enteral nutrition?

A

Consistent with medical and pt goals
Oral intake deemed unsafe, inadequate or impossible to meet nutrient needs
Func GI tract
Accessible GI tract

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7
Q

What are some conditions that require enteral support?

A

Impaired ingestion
Inability to consume adequate nutrition due to: condition or hyper-catabolic state
Impaired digestion and absorption
Severe wasting/malnutrition

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8
Q

What are some benefits of enteral nutrition?

A

Preserves GI tract integrity and func
Red infections and non-infectious complications associated with disease and injury
Less expensive than parenteral nutrition
Generally safer than parenteral nutrition

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9
Q

What are some contraindications of enteral nutrition?

A 
Non-operative mechanical GI obstruction
Paralytic ileus
Severe GI bleed
Perforation of GI tract
Inability to gain access to GI tract
Intervention not warranted or desired
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10
Q

What are the two routes for enteral nutrition?

A

Nasoenteric

Percutaneous enterostomy

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11
Q

What are the types of nasoenteric routes and what is the duration for this type of feeding?

A

Nasogastric (NG)
Nasoduodenal (ND)
Nasojejunal (NJ)
Short term(less than 3-4 weeks)

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12
Q

What are the types of percutaneous enterostomy routes and what is the duration for this type of feeding?

A 
Gastrostomy (PEG) or Jejunostomy (PEJ)
Long term (more than 4 weeks)
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13
Q

What are the categories of enteral formulas?

A

Polymeric Formulas: Req digestive capability

Semi-elemental formulas: Reg minimal digestion for absorption

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14
Q

In what situation would you use the different types of polymeric formulas?

A

Standard Formula: CVA with swallowing dysfunction
Higher Protein: Post-surg, pressure ulcer, burns, wounds, sepsis
Nutrient Dense: Hyper catabolism, fluid restriction

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15
Q

What is parenteral nutrition?

A

Infusion of a sterilized, specialized form of liquid nutrients through a vein into bloodstream via an IV catheter

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16
Q

What are two important factors to remember when providing parenteral nutrition?

A

Must be sterile

Cannot put anything but elemental substances

17
Q

What are some indications for parenteral nutrition?

A

Consistent with med and pt goals
Pt unable to meet nutrition needs with enteral nutrition
Pre-op support in severely malnourished pt
GI incompetency

18
Q

What are the TPN routes? (2)

A

Peripheral Parenteral Nutrition

Central Parenteral nutrition

19
Q

Is Peripheral TPN short or long term use?

A

Short term

20
Q

Is Central TPN short or long term use?

A

Long term

21
Q

What are some restrictions of peripheral TPN?

A

Often unable to meet caloric needs
Site rotation every 3-5 days
Principle complication - thrombophlebitis

22
Q

What are some contraindications for PN?

A

Func and usable GI tract
Prognosis does not warrant aggressive nutrition support
Aggressive intervention not wanted by pt
Risk judged to be greater than benefits

23
Q

What are some indications for TPN?

A

Hypermetabolic state with poor enteral tolerance and accessibility
GI tract not working

24
Q

What is refeeding syndrome?

A

Rapid nutritional repletion in severely malnourished pt

Hypernatremia, hypophosphatemia, hypokalemia and hypomagnesemia

25
Q

What kind of fluid and electrolyte imbalance do you see in refeeding syndrome?

A

Hypernatremia, hypophosphatemia, hypokalemia and hypomagnesemia
(High sodium, low phosphorous, potassium and magnesium)

26
Q

What are the complications of refeeding syndrome?

A

Fluid retention

Heart and resp failure

27
Q

What are the symptoms of refeeding syndrome?

A

Edema
Cardiac arrhythmias
Muscle weakness
Confusion

28
Q

What precautions should be taken to prevent refeeding syndrome?

A

Monitor glucose, electrolytes, PO4 and Mg every 3 days

Correct low serum levels prior to feeding

Nutrition (12 decks)

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