Enteral Nutrition Flashcards
to not die :)
What do you have to do before feeding?
do imaging to confirm placement of tube- radiologist will tell you
What is the normal lab value range for Potassium (K)?
3.5-5.0 mmol/L
What is the normal lab value range for phosphate (PO4)?
0.80-1.35 mmol/L
What is the normal lab value range for WBC?
4.0-11.0 E9/L
Which medications have sedative side effect?
sertraline (antidepressant), clonidine (antihypertensive), loxapine (schizophrenia)
What is a major advantage/benefit of using enteral nutrition?
maintains gut integrity & supports gut barrier function
when would EN be used?
when there’s a functional GI tract & clinical conditions in which oral intake is impossible, inadequate, or unsafe
What are enteral contraindications?
-non operative GI obstruction
-peritonitis
-severe short bowel syndrome (<100cm small bowel)
-ileus
-distal high output fistula
-sever GI bleed, malabsorption
-GI ischemia
-no access to GI tract
What is the RD enteral responsibilities?
-determine location of feed
-formula selection
-administration
-calculate nutrient requirements
-asses tolerance/S.E.
-monitor pt. condition
-transitional feeding
What are GI access sites?
where the tube enters the body and where tip of tube is located
what does deciding on an enteral route depend on?
-duration of need
-anatomy and function of GI tract
-equipment available
-risk of aspiration/HOB
What are the different GI access sites?
-nasogastric
-nasoduodenal
-nasojejunal
-orogastric
-gastronomy
-PEG (percutaneous endoscopic gastronomy)
what are the advantages of nasogastric feeding?
-uses and stimulates normal digestive function
-flexibility in administration
- medications can be placed in this tube
-tube insertion at bedside
what are the disadvantages of nasogastric feeding?
-aspiration
-discomfort for patient
-nasal irritation
-tube displacement
What are the indications of using nasogastric enteral access?
normal GI function
what are the advantages of nasoduodenal access?
-tube insertion at bedside
-uses and stimulates normal digestive function
-flexibility in administration
-medications can be placed in this tube
what are the disadvantages of nasoduodenal access?
discomfort for pt.
tube displacement
requires pump administration
what are the indications of using nasoduodenal enteral access?
-normal SI function
- need to bypass stomach as primary site of feeding
what are the advantages of using nasojejunal access?
what is the average osmolality range for EN formulas?
300-700 mOsm/kg
What determines EN formula osmolality?
-number and size of lytes, minerals, CHO
what is an isotonic formula?
osmolality matches physiological osmotic pressure (about 300 mOsm/kg)
-promotes best tolerance in acutely ill patients, preferred for small bowel feeding
what is a hypertonic formula?
osmolality is higher than physio osmotic pressure, induce shift of free water into intestinal space and cause diarrhea
- preferred for gastric feeding
