Enteral Nutrition Flashcards
Types of access that allow you to crush meds
Nasogastric (NG), orogastric (OG), nasoduodenal (ND), nasojejunal (NJ), gastrostomy (G-tube)
Types of access that don’t allow bolus feeds
Nasoduodenal, nasojejunal, jejunostomy (J-tube)
Short-term access routes
Nasogastric, orogastric, nasoduodenal, nasojeujunal
Long-term access routes
G-tube, J-tube
How does a patient qualify for a standard formula?
Their GI tract is functioning, they require enteral support, and they don’t have organ system dysfunction or another need for a specialty formula
How does a patient qualify for a specialty formula
Functioning GI tract, require enteral support, but they do have organ system dysfunction or another need for a specialty formula
Other route is if they were originally on a standard formula but can’t tolerate it
How do standard formulas vary?
Based on protein concentrations, Kcal/ml, fiber content
How are standard formulas selected?
Based on the patient’s protein needs
How do specialized formulas differ from each other?
Based on disease-specific modifications
When to give EN in the setting of critical illness
Within 48 hours of admission
What does giving early EN in critical illness do?
Attenuates the stress response, reduces inflammatory cytokines and lowers impact on gut permeability; may reduce disease severity and infectious complications with a trend towards reduction in mortality
What can hemodynamic instability result in with critical illness?
Bowel necrosis due to poor gut perfusion and increased oxygen demand
EN and bowel necrosis treatment
Delay EN until the patient is fluid resuscitated and vasopressors are being withdrawn or doses are reducing/stable
Early EN nutrition in previously well-nourished, mild-to-moderately stressed adult patients who aren’t critically ill
May delay initiation of EN for up to 5-7 days but early EN initiation isn’t usually warranted in patients like these
EN GI intolerance can contribute to what?
Aspiration
