Enteral Nutrition Flashcards
Used when a client cannot consume adequate nutrients and calories orally, but maintains a partially functional GI system
Enteral nutrition
NG tubes and Nasointestinal tubes are used for how long?
Short term - 3-4 weeks
Endoscopically placed and generally well tolerated by pt
PEG tube
Surgically inserted into the jejunal portion of sm intestine
Jejunostomy tubes
Preferred when long-term use is anticipated or when nasal obstruction makes insertion thru the nose impossible
Endoscopic or surgical placement of tube
Polymeric or intact formulas; composed of whole proteins or protein isolates; Require a functioning GI tract. Provide 1-1.2 cal/mL
Standard formulas
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
Hydrolyzed formulas
When should bags be discarded?
every 24 hr
Formula is administered at a continuous rate over a 16-24 hr period; recommended for critically ill clients
Continuous drip method
How often should residual volumes be measured in continuous drip feedings?
every 4-6 hr
How often should feeding tubes be flushed in continuous drip feedings?
Every 4 hr
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
Cyclic feedings
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
Intermittent tube feedings
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
Bolus feedings
Prior to instilling enteral feeding, what should be done?
Tube placement should be verified by radiography
What should you do with gastric residuals?
Return to stomach
How much should HOB be elevated during feedings and at least 30 min afterward?
At least 30 degrees
What temp should the feeding be administered at?
Room temp
How much and how often should you flush the tubing after giving medications?
Flushed with water (15-30 mL) before and after the medication is given, and between each medication if more than one is given
When can enteral feedings be d/c?
When the client consumes 2/3 of protein and calorie needs orally for 3-5 days
How do you prevent feeding tube obstruction?
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!
What should you do with unused portions?
Refrigerate promptly for up to 24 hr
How often should you replace the feeding bag and tubing?
every 24 hr
