Enteral Nutrition Flashcards
In order to have enteral nutrition, you must have _____ cm of working small bowel.
100
EN is recommended when adequate oral intake has not or will not be possible for ___ to ____ days
7 to 14 days
If a person has diffuse peritonitis, what type nutritional support should they get?
PN
A person should get a ______ tube if they will need EN for 4-6 weeks.
Nasogastric/ nasoenteric
A person should get ______ tube if they will need EN for a longer period of time.
Gastrostomy (G-tube) jejunostomy (J-tube)
PEG or PEG/J (Percutaneous Endoscopic Tubes)
Those with tolerance issues should be placed on what type feeding?
Continuous (start at 30 mL/ hour)
If a person has dumping syndrome, how soon after a feeding do symptoms occurs?
15-30 minutes
Too many _____ can cause dumping syndrome.
Refined sugars
Late dumping syndrome is associated with low _____.
Blood sugar
When checking a residual, what should the value be less than?
Less than double their hourly rate
How often are residuals checked in an acute-care setting?
Every 4 hours
For ever kcal a patient gets they should get ____ mL of water
1 mL
Before and after each bolus, an individual should receive __________ mL of water
60-90
To avoid aspiration, what should be done?
Head of bed should always be elevated at least 30 degrees
What two amino acids are often added to tube feeds?
Glutamine and arginine (Help with wound healing and perfusion)
If an individual has GI ischemia or an intestinal obstruction, what type nutritional support should they receive?
PN
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.
20-30 mL
For bolus feeding, you can start feedings at ____ mL over 20-40 minutes and then advance by 50-100 mL every feeding.
150-200 mL
What should you use to unclog a tube?
Sodium bicarb + pancreatic enzyme (NOT SODA)
What are some CV symptoms of dumping syndrome?
Flushing
Dizziness
Lightheadedness
Heart palpitations
What are contraindications for EN?
diffuse peritonitis intestinal obstruction intractable vomiting or diarrhea paralytic ileus GI ischemia pt refusing nutrition support
What are 5 causes of diarrhea?
Medications C. difficil colitis Underlying or unrecognized GI disorder Rate of TF delivery or type of formula Location and rate of delivery
How many hours is for continuous drip?
18-24hr
How much and for how long for intermittent feedings?
4-6 feedings per day
20-60min each feed
What are three methods for bolus feeding?
gravity, syringe, or pump
What volume and how frequently for bolus feeding?
3-4 feedings a day
500mL per feed
What are two combinations for nighttime pumps?
- nighttime pump feed (30mL from 10pm-6am) + Daytime bolus (240mL TID)
- nighttime pump and daytime PO (for transitioning)
What time frame is considered late dumping syndrome?
1-3 hours after eating related to insulin response
For flushing, how should meds be given?
crushed and with 30mL fluid flush
Explain initiation of continuous feedings
Initial rate= 30mL/hr
Advance 20-30mL every 6-8 hours until reach goal rate
Explain initiation of intermittent or bolus feedings
Initial rate= 150-200mL over 20-40 min
Advance 50-100mL every feeding as tolerated
