Enteral Nutrition

Question 1

In order to have enteral nutrition, you must have _____ cm of working small bowel.

Answer 1

100

Question 2

EN is recommended when adequate oral intake has not or will not be possible for ___ to ____ days

Answer 2

7 to 14 days

Question 3

If a person has diffuse peritonitis, what type nutritional support should they get?

Answer 3

PN

Question 4

A person should get a ______ tube if they will need EN for 4-6 weeks.

Answer 4

Nasogastric/ nasoenteric

Question 5

A person should get ______ tube if they will need EN for a longer period of time.

Answer 5

Gastrostomy (G-tube) jejunostomy (J-tube)

PEG or PEG/J (Percutaneous Endoscopic Tubes)

Question 6

Those with tolerance issues should be placed on what type feeding?

Answer 6

Continuous (start at 30 mL/ hour)

Question 7

If a person has dumping syndrome, how soon after a feeding do symptoms occurs?

Answer 7

15-30 minutes

Question 8

Too many _____ can cause dumping syndrome.

Answer 8

Refined sugars

Question 9

Late dumping syndrome is associated with low _____.

Answer 9

Blood sugar

Question 10

When checking a residual, what should the value be less than?

Answer 10

Less than double their hourly rate

Question 11

How often are residuals checked in an acute-care setting?

Answer 11

Every 4 hours

Question 12

For ever kcal a patient gets they should get ____ mL of water

Answer 12

1 mL

Question 13

Before and after each bolus, an individual should receive __________ mL of water

Answer 13

60-90

Question 14

To avoid aspiration, what should be done?

Answer 14

Head of bed should always be elevated at least 30 degrees

Question 15

What two amino acids are often added to tube feeds?

Answer 15

Glutamine and arginine (Help with wound healing and perfusion)

Question 16

If an individual has GI ischemia or an intestinal obstruction, what type nutritional support should they receive?

Answer 16

PN

Question 17

For continuous feeding, after starting a TF at 30 mL/hour you can advance by ____ every 6-8 hours as tolerated to get to goal.

Answer 17

20-30 mL

Question 18

For bolus feeding, you can start feedings at ____ mL over 20-40 minutes and then advance by 50-100 mL every feeding.

Answer 18

150-200 mL

Question 19

What should you use to unclog a tube?

Answer 19

Sodium bicarb + pancreatic enzyme (NOT SODA)

Question 20

What are some CV symptoms of dumping syndrome?

Answer 20

Flushing
Dizziness
Lightheadedness
Heart palpitations

Question 21

What are contraindications for EN?

Answer 21

diffuse peritonitis
intestinal obstruction
intractable vomiting or diarrhea
paralytic ileus
GI ischemia
pt refusing nutrition support

Question 22

What are 5 causes of diarrhea?

Answer 22

Medications
C. difficil colitis
Underlying or unrecognized GI disorder
Rate of TF delivery or type of formula
Location and rate of delivery

Question 23

How many hours is for continuous drip?

Answer 23

18-24hr

Question 24

How much and for how long for intermittent feedings?

Answer 24

4-6 feedings per day

20-60min each feed

Question 25

What are three methods for bolus feeding?

Answer 25

gravity, syringe, or pump

Question 26

What volume and how frequently for bolus feeding?

Answer 26

3-4 feedings a day

500mL per feed

Question 27

What are two combinations for nighttime pumps?

Answer 27

1. nighttime pump feed (30mL from 10pm-6am) + Daytime bolus (240mL TID)
2. nighttime pump and daytime PO (for transitioning)

Question 28

What time frame is considered late dumping syndrome?

Answer 28

1-3 hours after eating related to insulin response

Question 29

For flushing, how should meds be given?

Answer 29

crushed and with 30mL fluid flush

Question 30

Explain initiation of continuous feedings

Answer 30

Initial rate= 30mL/hr

Advance 20-30mL every 6-8 hours until reach goal rate

Question 31

Explain initiation of intermittent or bolus feedings

Answer 31

Initial rate= 150-200mL over 20-40 min

Advance 50-100mL every feeding as tolerated