Enteral Nutrition Administration, Monitoring, and Clinical Issues Flashcards
What is the maximum hang time for human breast milk?
4 hours
In critically ill patients receiving early EN, what is most likely to increase success in achieving goal feeding rate?
Use of a volume base EN feeding protocol
What is the optimal solution concentration of an oral rehydration solution (ORS) for patients with short bowel syndrome?
90-120 mmol/L
A patient with short bowel and end-jejunostomy requires the use of ORS to help prevent dehydration. What best describes the preferred composition of ORS?
An iso-osmolar solution such as juice diluted with 50% water
What is the best practice recommendation in EN formula safety?
Change the enteral feeding administration set every 24 hours
What is a benefit of closed enteral feeding systems?
Decreased risk for microbial contamination
What method of EN delivery is preferred for critically ill patients?
Continuous infusion
What type of feeding delivery method is most appropriate for patients with jejunostomy?
Continuous pump
Which enteral feeding method provides 240 ml of formula via a syringe over as few as 4-10 minutes, three to six times daily?
Bolus feeding
Most enteral formulas designed for oral consumptions are composed primarily of:
Carbohydrates
Which individuals would benefit from cyclic tube feedings?
Status post CVA who has initiated oral foods during the day
What tube feeding orders best reflects the use of intermittent schedule?
240 ml administered over 45 min, five times a day
Which feeding schedule would be most appropriate for a critically ill patient with poorly controlled blood glucose?
Continuous
What should always appear on the label of EN formula given to a patient in the hospital?
Patient ID, product name, administration method, route, access device, date and time of the formula was prepared and hung
When transitioning from EN to oral feeding, tube feeding my be discontinued when adequacy of oral intake meets at least:
66% of nutrient needs
Which type of insulin should be used when initiating EN on a hospitalized diabetic patient?
Regular (short acting) insulin
Which patient is at a lowest risk of pulmonary injury from small bore feeding tube misplacement?
A patient who is alert and cooperative
The initiation of EN should be delayed when the patient is:
Hemodynamically unstable
When initiating and advancing EN in hospitalized patient, what order is the most appropriate?
Full strength formula at 10-40 ml/hr and advancing to goal rate in 1-2 days.
One method of minimizing the complications associated with refeeding syndrome is to initiate electrolyte replacement before nutrition therapy begins. What is true regarding this plan?
Patients even considered not at risk should be included in protocol
Your patient is showing outwards signs of tube feeding intolerance including nausea and abdominal distention. The nurse checks gastric residuals and the last three measurements are 265 ml, 250 ml, and 330 ml. What is the most appropriate recommendation?
Consider adding a motility agent
When a patient is receiving a protein modulator, what is important to discuss with the family to prevent tube feeding syndrome?
The importance of providing adequate free water each day
What is true regarding infectious complications associated with EN?
Bacterial contamination may originate from the patients throat, lung, and stomach
An EN patient is experiencing abdominal distention but his residuals were 100 ml, what is appropriate strategy to alleviate symptoms?
Determine last bowel movement and initiate a bowel regimen if constipation is suspected?
