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Advanced Medical Nutrition Therapy II > Enteral Nutrition Support (part 1) > Flashcards

Enteral Nutrition Support (part 1) Flashcards

1
Q

_____ ____ is the provision of nutrients into the GIT through a tube

A

Enteral nutrition

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2
Q

Indications for enteral nutrition:

A

-Poor appetite
-Dysphagia
-Oral or esophageal trauma or cancer
-Altered mental status; comatose state
-Mechanical intubation
-Malnutrition
-Hypermetabolic states (ex: severe burns, CF)
-Gastroparesis; total gastrecotmy

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3
Q

Relative contraindications for enteral nutrition (indications for parenteral):

A

-Malfunctioning small bowel
-Severe bowel inflammation
-Hemodynamically unstable
-Expected short-term duration
-Terminal illness

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4
Q

What causes a malfunctioning small bowel:

A

-Small bowel obstruction
-Small bowel ileus
-Severe GI hemorrhage
-Intractable vomiting or diarrhea
-Severe malabsorption
-Severe short bowel syndrome
-High output small bowel fistula (>500 mL/day)

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5
Q

Benefits of enteral nutrition (compared to parenteral nutrition):

A

-Maintains small bowel function (digestive and absorptive capacity, mucosal barrier function and integrity-> prevention of bacterial translocation)
-More effective metabolism and utilization of nutrients (1st pass metabolism)
-Provides luminal nutrients: glutamine, may provide fiber
-Avoid the complications of parenteral nutrition
-Lower cost that parenteral nutrition

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6
Q

What are the general characteristics of feeding tubes?

A

-Material: polyurethane or silicone
-Lumen
-Eyelets
-Ports (may contain additional ports for irrigation and medication administration)

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7
Q

The outer diameter of the tube lumen is designated by ____ units (1 Fr = 0.33 mm)

A

French

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8
Q

For _____ feeding, the smallest tube diameter possible should be used for patient comfort

A

Nasoenteric

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9
Q

We should not use fiber-containing formulas with tubes that are less than ____ French

A

8

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10
Q

A nasogastric tube should only be used for short term, less than ___-___ weeks

A

4-6

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11
Q

Nasogastric tubes require proper ____ functioning

A

Stomach

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12
Q

Nasogastric tubes are around ____-____ inches in length

A

40-43

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13
Q

Nasogastric tubes are typically ____-____ French

A

8-12

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14
Q

Nasogastric tubes are inserted at the bedside by _____ or _____

A

MD, RN

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15
Q

You must confirm the placement of an NG with an ____

A

X-ray

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16
Q

There are also NG ____/____ tubes

A

Suction/drainage

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17
Q

NG tubes take advantage of normal _____ and _____ processes in the stomach

A

Digestive and bactericidal

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18
Q

One advantage of NG tubes is that any ____ methods can be used

A

Administration

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19
Q

Another advantage of NG tubes is that it is easily placed and does not require ____ or a medical procedure

A

Surgery

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20
Q

NG tubes are also more ____ effective than other tubes

A

Cost

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21
Q

What are disadvantages/possible complications of an NG tube?

A

-Increased risk of misplacement on insertion
-Easily displaced
-Sinusitis and nasal erosion
-Increased risk of clogging
-Increased risk of GERD leading to aspiration
-Cosmetically unappealing

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22
Q

A nasoduodenual tube is also used for short-term use, less than ____-___ weeks

A

4-6

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23
Q

Indications of a nasoduodenal tube:

A

-Delayed gastric emptying
-Gastroparesis

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24
Q

You need to confirm the tip location of a nasoduodenal tube with an ____

A

X-ray

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25
A complication with a nasoduodenal tube is...
The tip often coils or pulls up into the stomach
26
You cannot use ___ or ____ feeding with a nasoduodenal tube
Bolus, intermittent
27
Nasojejunal tubes are also used for short-term, less than ___-___ weeks
4-6
28
Nasojejunal tubes are between ___-___ inches in length
55-60
29
Nasojejunal tubes have a small bore size of ___-___ French
8-10
30
Nasojejunal tubes are placed endoscopically or fluoroscopically to confirm the tip is past the ____ _____ _____
Ligament of Treitz
31
"____" bedside placement of a nasojejunal tube is challenging
Blind
32
Indications for the use of a nasojejunal tube:
-Delayed gastric emptying -Persistent nausea -Severe, acute pancreatitis -High aspiration risk
33
Advantages of nasojejunal tube feeling:
-May reduce risk of aspiration -Can still feed into the small bowel while providing gastric suction
34
Disadvantages of nasojejunal tube feeding:
-Difficult placement -Tube displacement -Sinusitis; nasal necrosis -Cosmetically unappealing -Prone to clogging due to small bore size -Potential GI intolerance (the jejunum is sensitive to high volume or hyperosmolar feeding)
35
You cannot use ____ or ____ feeding with a nasojejunal tube
Bolus or intermittent
36
A tube _____ is when a tube is surgically or endoscopically placed into the GIT via the abdominal wall
Enterostomy
37
Indications for the use of tube enterostomy:
-Long-term enteral nutrition: >4-6 weeks -Dementia -Neurological disease -Chronic severe dysphagia -Oral, esophageal, or gastric cancer
38
A Percutaneous Endoscopic Gastrostomy (PEG) tube is used for ___-___ feeding and requires an endoscopic placement
Long term
39
A PEG tube requires someone to have a proper functioning ____
Stomach
40
Contraindications for a PEG tube:
-GI obstruction proximal to the stomach -Obesity -Ascites -Gastric varices
41
A PEG tube is between ___-___ French
15-28
42
Advantages of a PEG tube:
-No surgery required -More physiologic for digestion and absorption -More comfortable and aesthetic -Can use any administration method -Decreased risk of clogging secondary to larger bore size -May decrease risk of aspiration (compared to NG tube)
43
Disadvantages/possible complications with a PEG tube:
-If dislodged, must be replaced within a few hours or the tract will close -Site infection -Potential for skin breakdown from leakage of gastric contents -Migration of internal bumper through the gastric wall
44
Migration of the internal bumper of a PEG tube through the gastric wall can cause possible leakage of gastric contents internally, causing _____
Peritonitis
45
A gastrostomy tube (GT) use used for ___-___ feeding and must be surgically placed
Long-term
46
In order for a G tube to be used, a patient needs to have a well-functioning ____
Stomach
47
A G tube is indicated for...
-Patients requiring enteral nutrition who are either undergoing a surgical procedure or cannot undergo endoscopic placement
48
G tubes are usually between ____-____ French
15-28
49
Advantages of G tubes:
-More physiologic for digestion and absorption -More comfortable and aesthetic -Can use any administration method -Decreased risk of clogging secondary to larger bore size -May reduce risk of aspiration (compared to NG tube)
50
Disadvantages/possible complications of G tubes:
-Requires surgery and general anesthesia -Potential for skin breakdown from leakage of gastric contents -Site infection -Dislodgement of the tube; peritonitis -Migration of internal bumper through the gastric wall
51
A Jejunostomy Tube (JT) is for long-term use and is ____ placed
Surgically
52
Indications of a J tube:
-Gastroparesis -Total gastrectomy -Chronic N/V -Total esophagectomy
53
What administration methods of feeding can be used with a J Tube?
-Pump-controlled continuous infusion -Cyclic feeding
54
J Tubes are between ___-___ French
10-20
55
Advantage of a J Tube:
-Decreases aspiration risk
56
Disadvantages of a J Tube:
-Dislodgement; difficult to replace -Occlusion -Wound infection; skin erosion -Potential GI intolerance to goal rates/volumes (no bolus or intermittent feeding) -Bowel obstruction
57
A ____ ____ Jejunostomy is a very small bore tube, around 5-8 French
Needle Catheter
58
Disadvantages of a needle catheter jejunostomy:
-Easily dislodged -Clogs easily (fiber-containing formulas are not recommended)
59
A Gastrojeunostomy (GJ Tube) is a ____-____ tube
Multi-lumen
60
With a GJ Tube, one lumen is for ____ ___, while the second lumen feeds into the jejunum
Gastric suction
61
A GJ Tube can be used if someone has long-term ____ with severe nausea
Gastroparesis
62
GJ Tubes are placed with ____ or ____ placement
Surgical or endoscopic
63
With a GJ tube, the G tube is ___-___ French while the J Tube is ___-___ French
15-28; 6-12
64
Advantages of GJ Tubes:
-Simultaneous gastric decomposition/drainage and feeding into small bowel -Reduced aspiration risk
65
Disadvantages of GJ tubes:
-Risk of bleeding and infection of the abdominal wall -Migration of internal bumper through the gastric wall -Dislodgement -Cannot use bolus or intermittent feeding
66
Factors used to determine the optimal enteral access route:
-Anticipated duration of enteral feeding -Condition/function of the stomach -Risk of aspiration -Planned surgical intervention

Advanced Medical Nutrition Therapy II (19 decks)

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