Enteral Nutrition Flashcards
When can you provide enteral nutrition regarding the GI tract?
If there is an intact, functional, an unobstructed GI tract
When should you give enteral nutrition? 3
- Supplemental nutrition needed for extended period of time
- Oral nutrition is not indicated
- Lethargic patients with significant risk of aspiration
What are 4 contraindications to enteral nutrition?
- Severe malabsorption syndromes
- GI obstruction or ileus
- Intractable diarrhea
- Palliative care
What are the 3 different types of tube feeding?
- Nasoenteric tube feeding
- Orogastric tube feeding
- Enterostomy tube feeding
What is the initial rate for continuous tube feeds?
25 mL/hr and increase slowly
What is the goal for continuous and intermittent feeding?
Full replacement over 24 hours
What type of feeding is better tolerated?
Continuous
What type of feeding is harder to tolerate as an outpatient?
Intermittent
What are 3 types of enteral nutrition?
- Meal replacement
- Elemental/ peptide
- Disease specific
What products are used for meal replacement enteral nutrition? 3
- Ensure
- Osmolite
- Isosource
When can elemental/peptide enteral nutrition be used? 2
- Patients w malabsorption issues (Crohns, severe IBS)
- Transition from TPN to enteral
What 3 products are used for elemental/peptide enteral nutrition?
- Vivonex
- Peptamen
- Vital
What are two specialty feedings used for respiratory insufficiency?
- Pulmocare
- Respalor
What are 2 specialty feedings used for diarrhea?
- Jevity
- Ultracal
What are 2 specialty feedings that are used for renal insufficiency?
- Nepro
- Suplena
What specialty feeding is used for diabetes?
Glucerna
How do you maintain hydration when tube feeding?
By administering free water via tube
What is a very common issue with tube feeding?
Diarrhea
What are 4 ways to manage diarrhea with tube feeding?
- Decrease amount
- Decrease rate
- Add fiber
- Anti diarrheal agents
What should you do if a patient is presenting with nausea and vomiting because of tube feeding?
- Decrease rate of tube feeds
- Consider octreotide
- Can give metoclopramide and erythromycin
What formulations of medications should be used when a patient has tube feeds?
Liquid formulations
What should you do after administering medications in the tube feed?
Flush with water after every medication
What formulation of medications shouldn’t be be used with tube feeding?
Extended release
What are 8 medications that are issues with tube feeding?
- Sucralfate
- Phenytoin
- Valproate acid
- Levothyroxine
- Quinolones
- Tetracyclines
- Griseofulvin
- Warfarin
What is the pH like in the stomach?
Acidic
What is the pH like in the duodenum?
Alkaline
What two medications have an issue if they are placed in the duodenum instead of the stomach?
- Ketoconazole
- Omeprazole
What are 2 ways that you can unclog the tube feed?
- Distilled water
- Pancreatic enzymes
What pancreatic enzyme can be used with sodium bicarbonate to dissolve the clog?
Viokace
If there is a need for long term tube feeds, what does nasogastric need to be converted to?
PEG tube
