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Alimentary System > Enteral feeding > Flashcards

Enteral feeding Flashcards

1
Q

When is enteral feeding indicated?

A

In patients who have an inability to maintain oral intake with a functioning GI tract

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2
Q

What are the consequences of malnutrition?

A

Physical decline
Impaired psychosocial function
Function decline
Reduced QoL
Poor clinical outcomes
More healthcare use

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3
Q

What screening tool is used to identify patients who are malnourished, at risk of malnourishment or obese?

A

Malnutrition Universal Screening Tool (MUST)

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4
Q

What is step 1 of MUST?

A

BMI score

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5
Q

What is step 2 of MUST?

A

Weight loss score

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6
Q

What is step 3 of MUST?

A

Acute disease effect score (eaten in the last 5 days)

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7
Q

What equation is used for calorie estimation?

A

Schofield equation

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8
Q

What is bolus feeding?

A

Give feed, supplements, water and medication as a bolus by syringe when required.
Only purple enteral syringed can be used with feeding tubes

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9
Q

What is an alternative to bolus feeding?

A

Continuous method with an enteral feeding pump and a giving set

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10
Q

What are absolute contraindications to enteral feeding?

A

Intestinal obstruction
Severe ileus
Intestinal perforation
Proximal GI fistula
Refusal in a competent patient

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11
Q

How do you check the position of the NG tube?

A

Aspirating and testing the pH.
pH between 0 and 5 is in the stomach and safe to use

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12
Q

What is NG tube used for?

A

Short term feeding only

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13
Q

What are some examples of NG use?

A

Swallowing disorders
Head and neck cancers
CF
Anorexia nervosa

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14
Q

What are absolute contraindications to NG use?

A

Basal skull fracture
Nasopharyngeal/ oropharyngeal pathology prevents passage of tube

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15
Q

What are the relative contraindications to NG use?

A

Nasal problem
Previous traumatic insertion

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16
Q

What are the risks of NG use?

A

Malposition into lungs or intracranially
Removal by patient
Tube blockage
Oesophageal/ gastric ulceration

17
Q

What is NJ feeding?

A

Nasojejunal
Tubes run through pylorus into jejunum to deliver post pyloric feeding
Inserted under direct vision in endoscopy

18
Q

What are some examples of NJ use?

A

Delayed gastric emptying
Reflux causing an aspiration risk
Upper GI surgery
Pancreatitis

19
Q

What are absolute contraindications to NJ use?

A

Basal skull fracture
Nasopharyngeal/ oropharyngeal pathology prevents passage of tube
Gastric outlet obstruction

20
Q

What are relative contraindications to NJ use?

A

Inability to pass endoscope

21
Q

What are the risks of NJ use?

A

Malposition into lungs or intracranially
Removal by patient
Tube blockage
Oesophageal/ gastric ulceration
Post-pyloric position not sustained

22
Q

What are the three types of gastrostomy?

A

PEG
RIG
Surgical

23
Q

What does PEG stand for?

A

Percutaneous Endoscopic Gastrostomy

24
Q

What does RIG stand for?

A

Radiologically Inserted Gastrostomy

25
Q

When is a gastrostomy indicated?

A

When enteral feeding will be required long term (>30 days)

26
Q

What are absolute contraindications to gastrostomy?

A

Inability to pass endoscope due to pathology
Gastric Outflow Obstruction
Planned curative oesophageal resection

27
Q

What are relative contraindications to gastrostomy?

A

Coagulopathies
Peritoneal dialysis
Gastroparesis
Portal HTN
Gastric ulcer
Gastric malignancy
Gastrectomy
Severe obesity
Oesophageal cancer
Active infection

28
Q

What are the risks of gastrostomy?

A

Pain
Haemorrhage
Peritonitis
Pneumoperitoneum
Gastrocolic fistula
Infection
Blockage
Over granulation

29
Q

What are the three types of jejunostomy?

A

PEJ
PEG-J
Surgical

30
Q

What is PEJ?

A

Percutaneous Endoscopic Jejunostomy

31
Q

What is PEG-J?

A

PEG with Jejunal extension

32
Q

What is the indication for Jejunostomy?

A

Patient requires long term feeding and post-0pyloric feeding

33
Q

What are absolute contraindications to jejunostomy?

A

Inability to pass endoscope
Jejunal disease at insertion site
Intestinal obstruction distal to site

34
Q

What are relative contraindications to jejunostomy?

A

Coagulopathies
Portal HTN
Ascites
Peritoneal dialysis

35
Q

What are the risks of jejunostomy?

A

Pain
Haemorrhage
Peritonitis
Infection
Blockage
Post pyloric position not sustained

Alimentary System (24 decks)

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