Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medical Nutrition Therapy > Enteral Nutrition > Flashcards

Enteral Nutrition Flashcards

1
Q

What is nutrition support?

A

Delivery of formulated enteral or parenteral nutrients to maintain or restore nutritional status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Define enteral nutrition

A

Enteral nutrition (EN): provision of nutrients into GI tract through tube when oral intake is inadequate
(may include formulas as oral supplements or meal replacements)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Define parental nutrition

A

provision of nutrients intravenously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

List some of the impacts of malnutrition

A

Malnutrition – impacts on:
- Recovery from illness/surgery
- Risk of infection
- Wound healing
- Hospital stay
- Costs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the benefit of Early commencement of feeding

A

reduce mortality and post-op complications (within 24 hours)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the benefits of EN vs PN

A

Better gastrointestinal barrier function
* Preserved gastrointestinal immunity
* Preserved gut-associated lymphoid tissue (GALT)
activity
* Decreased rates of infection presumably unrelated
to GI tract (no central line or PICC)
* Cost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some conditions that often require EN?

A

Impaired nutrient ingestion such as neurologic disorders, HIV/AIDS, facial trauma, oral or esophageal trauma, congenital anomalies,
cystic fibrosis, traumatic brain injury

Inability to consume adequate nutrition orally: for example hyperemesis of pregnancy; hypermetabolic states such as burns and trauma, respiratory illness

Impaired digestion, absorption, metabolism
: from severe gastroparesis, inborn errors of metabolism, Crohn’s disease, short bowel syndrome with minor
resection

Severe wasting or depressed growth * cystic fibrosis, failure to thrive, cancer, sepsis, cerebral palsy

Non-functioning parts of the upper GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the Nasogastric route and the advantages and disadvantages

A

Gastric = into stomach
Beetter for Short-term: up to 3 or 4 weeks
and requires Normal GI function
ADV:
* Large reservoir
* Maintain gut function
* Bolus, intermittent, or continuous infusions
DIS:
* Increased risk of oesophageal reflux and/or aspiration
* Facial irritation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some considerations for EN access?

A

EN access depends on:
Anticipated length of time of enteral feeding
* Risk for aspiration or tube displacement
* Presence/absence of normal digestion and absorption
* Gastric = into stomach
* Duodenal = into the first part of the small intestine
* Jejunal = into the second part small intestine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the advantages and disadvantages of the Nasoduodenal or nasojejunal route EN?

A
  • Short-term: up to 3 or 4 weeks
  • Gastric motility disorders, esophageal reflux, or persistent nausea and vomiting

ADV:
* Can be used for early enteral feeding (4-6 hours after trauma)
* May reduce risk of reflux/aspiration

DIS:
* Intolerance
* Can be more difficult to place
* Risk of displacement/migration
* No gastric acid barrier against bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the advantages and disadvantages of a PEG (percutaneous endoscopic gastrostomy)

A
  • Nonsurgical technique
  • Preferred for longer than 3 to 4 weeks

ADV:
* Large reservoir
* Maintain gut function
* Bolus, intermittent, or continuous infusions

DIS:
* Increased risk of oesophageal reflux and/or aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the advantages and disadvantages of a PEJ (percutaneous endoscopic jejunostomy)

A

Nonsurgical technique
* Preferred for longer than 3 to 4 weeks

ADV:
* Can be used for early enteral feeding
* May reduce risk of reflux/aspiration

DIS:
* Intolerance
* Can be more difficult to place
* Risk of displacement/migration
* No gastric acid barrier against bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The suitability of a feeding EN formula should be evaluated based on:

A

Functional status of GI tract
* Physical characteristics of formula (osmolarity, powdered/ready-made)
* Energy and nutrient content
* Digestion and absorption capability of the patient
* Clinical considerations, such as fluid and electrolyte status and organ/system function
* Cost-effectiveness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the osmolarity of EN Formula?

A

Osmolality
o The concentration of a solution expressed as the total number of solute particles per kg
o Iso-osmolar (300-500mOsm/kg) – same as blood
o Facilitates gastric emptying and optimises absorption
o Higher = inhibit gastric emptying
o Be careful when feeding directly into the small bowel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

EN Formula selection

A

Generally, use standard polymeric feed (1kcal/ml) e.g. jevity or nutrision multi fibre, osmolite or nutrision
standard; but may also use standard no fibre e.g. Osmolite
* Might use specialist feed e.g. nepro, novasource renal, Jevity Hi Cal, semi-elemental, elemental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are some considerations with EN administration?

A
  • Feeds are heat and light sensitive
  • Closed feeds – can hang for 24 hours
  • Open feeds – can hang for 4 hours max
  • Hospitals will usually make up 24 hours of feed at a time and store in bottles (eg. QCH uses 130ml and 240ml bottles, can order any amount of formula in 10ml increments. Adult facilities usually use
    ready to hang versions)
17
Q

how should the bed be positioned for feeds?

A

Positioning – Head of bed at 30–45-degree angle

18
Q

what are the three types of EN administration?

A

Continuous: via gravity/infusion pump (flow rate ranges from 1 to 400ml/hr in 1ml increments)
- Generally, start with 20-40ml/hr for 4-6/24 and increase by 20ml/hr every 4-6/24 as tolerated (adults)

Intermittent/cyclic: as above 4–16-hour break

Bolus: up to 50-500 ml rapid delivery via syringe/gravity 3 or 4 times (or more) daily
- Start small and increase as tolerated

19
Q

why are water flushes important and how often should they occur

A

Water flushes
* Minimises blockages and ensures tube patency
* Contributes to fluid requirements
* Continuous feeds: flush 4 to 6 hourly
* Intermittent feed: flush at start and end of feed + q4hrly
* Bolus feeds: flush before and after feeds and meds
* Can do additional flushes to meet fluid requirements

20
Q

what are some complications of enteral feeding?

A
  • Access problems (eg. tube displacement or obstruction, leakage)
  • Administration problems (eg. aspiration, regurgitation, microbial contamination, inadequate delivery)
  • Gastrointestinal complications (eg. nausea/vomiting, delayed gastric emptying, high gastric residuals,
    constipation, diarrhea, malabsorption, ileus)
  • Metabolic complications (eg. refeeding syndrome, glucose intolerance, dehydration/overhydration, drugnutrient interactions)
21
Q

what is refeeding syndrome (RFS)?

A

“Metabolic and electrolyte alterations occurring as a result of the reintroduction and/or increased provision
of calories after a period of decreased or absent caloric intake” – ASPEN Consensus Recommendations
for Refeeding Syndrome, 2020

22
Q

What is the diagnosis criteria for RFS (refeeding syndrome)

A

Specifically, RFS diagnostic criteria are outlined as the following:
* A decrease in any 1, 2, or 3 of serum phosphorus, potassium, and/or magnesium levels by 10%–20%
(mild RS), 20%–30% (moderate RS), or >30% and/or organ dysfunction resulting from a decrease in
any of these and/or due to thiamin deficiency (severe RS).
* And occurring within 5 days of reinitiating or substantially increasing energy provision

23
Q

Describe the management of RFS in at risk patients.

A

Slow increase of feeds or oral intake – main concern is glucose intake
* 42-84kJ/kg for first 24hrs
* Increase by 33% every 1-2 days until goal rate achieved
* If at high risk wait until electrolytes are supplemented before increasing feeds

Monitor electrolytes - K, Mg, PO4
* Before and daily once feeds are commenced
* If any low à Electrolyte repletion – medical team to commence
* Thiamine 100mg before feeds start and daily after
* Supplement with routine MV at least 10 days

24
Q

What needs to be monitored in patients recieving EN?

A

Weight (at least 3 times/wk or minimal weekly)
* Signs and symptoms of edema (daily)
* Signs and symptoms of dehydration (daily)
* Fluid intake and output (daily)
* Adequacy of enteral intake (at least 2 times/wk)
* Abdominal distention and discomfort
* Serum electrolytes, blood urea nitrogen, creatinine, (2-3 times/wk)
* Serum glucose, calcium, magnesium, phosphorus, (weekly or as
ordered)
* Stool output and consistency (daily)

25
Q

how to transition from EN to oral

A
  • Reduce enteral to night only to reestablish hunger/satiety cues (if safe)
  • Remove from continuous feeding to a 12- then 8-hour formula administration cycle
  • Cease feeds during mealtimes
  • May reduce size of bolus feeds
  • Need to monitor both EN and oral intake effectively to guide decision making
  • Think about fluids

Medical Nutrition Therapy (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions