Enteral Nutrition Flashcards
buckle up, this is gonna be LONG AND HARD :D
What is Enteral Nutrition?
Who is nutritional support like Enteral and prenteral feeding considdered for
- Malnourished (BMI under 18.5, 10% wightloss in 3-6m OR BMI 20 and the weightloss)
- People at risk of malnutrition, (poor absorbtion, not eaten in 5 days
- seriously ill.
Why would artificial NT support be considered?
- person cannot eat
- ## gut doesn’t function.
what is enteral Nutrition
Nutrition provided via the gastrointestinal trackt using a tube
does enteral nutrition require the gut to work?
YES!
Where is the tube placed? and Via what?
placed into:
Stomach
duodenum
jejunum
Via:
Nose
mouth
direct route (through skin)
What are some indications for Enteral Feeding?
Neuromuscular swallowing disorder.
-Parkinson’s
-MS
GI dysfunction/Malabsorbtion.
- IBS
Mental health
- Anorexia nervosa
- Depression
- Dementia
What are some contraindications of Enteral Tube feeding
Necrossis of GI
Intestinal obstruction
Severe malabsorbtion
when bowel rest is recommended (crohn’s)
What are the SHORT TERM routes for enteral access? How long is short term access.
4-6 weeks ish
Gastric:
- Nasogastric
- Orogastric
post-pyloric (into the intestines, past the stomach
- nasoduodenal
- nasojejunal
What are the LONG term routes for enteral feeding? How long
4-6 weeks +
Gastric
- Percutanous endoscopic gastrostomy (PEG)
- surgical gastrostomy
- radiologically inserted gastrostomy (RIG)
Post Pyloric
- PEG with jejunal ext
Percutaneous Endoscopic jejunotomy (PEJ)
- radiologically inserted jejunotomy
Describe Nasogastric feeding tube
- short term
- through nose into stomach
- NG
-bedside.
describe orogastic feeding
orally to stomach
short term
OG
How is positioning og the tube confirmed before feeding begins?
pH of aspirate using ph strips
xray.
what methods are not recommended to test for tube positioning
whoos test
Ausculation of air unsufflated through tube.
who are nasogastric tubes used for. Why?
Most common, everyone.
small and flexible, 1-2mm diameter, 12Fr.
guide wire.
Describe Nasoduodenal feeding?
through nose, into duodenum.
describe nasojejunal feeding?
nose to jejunum.
Why/when use post-pyloric feeding?
patient has slow gastric emptying
risk of refluc or aspiration.
what is a nasal retention device?
a little piece of plastic placed in the nose to prevent the feeding tube from displacing of NJ or NG (nose).
Describe Gastrostomy feeding
Long term
most common long term. decreses nasal irritation and need for feeding pump.
PEG into stomach
can be used 4h after insertion.
Describe Jejusnostomy
Long term
safe to use 24h after use
long term tube directly into jejunum
what are some contradicitions to PEG (dirrectly into stomach)
no stomach (duh)
coagulation disorder
haemodynamic insatbility.
describe a few considerations for Jejunal feeding? (there is a lot)
- increased risk of infection. Must be sterile, no touch. The tube doesnt go through stomach, hard to kill microbes
- can become blocked easily. need to be flushed frequently.
- feed type must be considered. dfat absorbrion is altered, less mix with bile and enz
- radiological guidance, need to expose to radiation.
- BUT. safer and less expensive than in vain.
what are the delivery methods for feeding?
Bolus (with/without plunger)
Pump assisted
Describe bolus feeding?
Gastorstomy only
deliver 240 to 480 ml of feed over 10-15 minutes.
this simulates meal time, give 1-2 bottles, 3-4 times a day.
can move around freely.
no pump
describe pump assisted
used for patients acutely ill
delivers into small intestine
how is feed selected?
dietician undertakes assesment
