Enteral Nutrition

Question 1

Used when a client cannot consume adequate nutrients and calories orally, but maintains a partially functional GI system

Answer 1

Enteral nutrition

Question 2

NG tubes and Nasointestinal tubes are used for how long?

Answer 2

Short term - 3-4 weeks

Question 3

Endoscopically placed and generally well tolerated by pt

Answer 3

PEG tube

Question 4

Surgically inserted into the jejunal portion of sm intestine

Answer 4

Jejunostomy tubes

Question 5

Preferred when long-term use is anticipated or when nasal obstruction makes insertion thru the nose impossible

Answer 5

Endoscopic or surgical placement of tube

Question 6

Polymeric or intact formulas; composed of whole proteins or protein isolates; Require a functioning GI tract. Provide 1-1.2 cal/mL

Answer 6

Standard formulas

Question 7

Elemental formulas; composed of partially digested protein peptides and are referred to as free amino acids; used for clients with partially functioning GI tract or for those who have an impaired ability to digest and absorb foods (i.e. IBD, cystic fibrosis). Provide 1-1.2 cal/mL, some provide 1.5-2.0 if high calorie

Answer 7

Hydrolyzed formulas

Question 8

When should bags be discarded?

Answer 8

every 24 hr

Question 9

Formula is administered at a continuous rate over a 16-24 hr period; recommended for critically ill clients

Answer 9

Continuous drip method

Question 10

How often should residual volumes be measured in continuous drip feedings?

Answer 10

every 4-6 hr

Question 11

How often should feeding tubes be flushed in continuous drip feedings?

Answer 11

Every 4 hr

Question 12

Formula is administered a continuous rate over an 8-16 hr time period, often during sleeping hours; often used to transition from total EN to oral intake

Answer 12

Cyclic feedings

Question 13

Formula is administered every 4-6 hr in equal portions of 200-300 mL over a 30-60 min time frame, usually by gravity drip; often used for noncritical pts, home-tube feedings, and clients in rehab

Answer 13

Intermittent tube feedings

Question 14

Lg volume of formula (500 mL max, usual volume is 250 to 400 mL) is administered over a short period of time, usually less than 15 min, 4-6x a day; may cause dumping syndrome

Answer 14

Bolus feedings

Question 15

Prior to instilling enteral feeding, what should be done?

Answer 15

Tube placement should be verified by radiography

Question 16

What should you do with gastric residuals?

Answer 16

Return to stomach

Question 17

How much should HOB be elevated during feedings and at least 30 min afterward?

Answer 17

At least 30 degrees

Question 18

What temp should the feeding be administered at?

Answer 18

Room temp

Question 19

How much and how often should you flush the tubing after giving medications?

Answer 19

Flushed with water (15-30 mL) before and after the medication is given, and between each medication if more than one is given

Question 20

When can enteral feedings be d/c?

Answer 20

When the client consumes 2/3 of protein and calorie needs orally for 3-5 days

Question 21

How do you prevent feeding tube obstruction?

Answer 21

Flush the tube with 20-60 mL of warm water after use and every 4 hr, and by avoiding dry products and administering crushed meds. Be sure to include water used to flush the tube in daily intake!

Question 22

What should you do with unused portions?

Answer 22

Refrigerate promptly for up to 24 hr

Question 23

How often should you replace the feeding bag and tubing?

Answer 23

every 24 hr