Enteral & Parenteral Nutrition Exam 3

Question 1

What is enteral nutrition?

Answer 1

Nutrition that is going directly to the GI tract, and the digestive system still processes the food

Question 2

How often should the patency of the tubing and placement be assessed?

Answer 2

every 4 hours

Question 3

How should you assess a patient receiving nutrition?

Answer 3

shape and feel of the abdomen
bowel sound presence
tenderness w/ palpation
stability of the tube
daily weights and accurate I&Os
glucose checks for 1st 24 hours

Question 4

What level should the HOB be at while feeding?

Answer 4

30-45 degrees

Question 5

What should you do before and after every feeding?

Answer 5

flush w/ water 30mls if not cont
if cont. flush every 4-6 hours and check residual

Question 6

What should you do if the residual is >500ml?

Answer 6

do not return and call provider

Question 7

What should you do if the residual is <500ml?

Answer 7

return to the stomach

Question 8

What should you obtain before the initial feeding?

Answer 8

Abdominal x-ray

Question 9

What are some potential complications of enteral feeding?

Answer 9

Overfeeding
Diarrhea
Aspiration pneumonia

Question 10

What are the nursing actions for overfeeding?

Answer 10

check residuals every 4-6 hours
feedings may need to be slowed or withheld
ensure the pump is working correctly

Question 11

What are the signs of overfeeding?

Answer 11

N/V
Abdominal distention
fluid overload
hyperglycemia

Question 12

What is the main cause of aspiration pneumonia?

Answer 12

tube displacement
can be life-threatening

Question 13

What are the nursing actions for aspiration pneumonia?

Answer 13

STOP feeding
suction airway (lying on side)
O2
watch for fever
chest x-ray
auscultate breath sounds

Question 14

How do you know if the tube is in the stomach?

Answer 14

pH < 4

Question 15

How do you know if the tube is in the jejunum?

Answer 15

pH > 6

Question 16

What is parenteral nutrition?

Answer 16

Nutrition is delivered directly to the bloodstream

Question 17

What is parenteral composed of?

Answer 17

amino acids (protein)
dextrose
electrolytes
minerals
vitamins
fat emulsions can be added although given separately

Question 18

How does parenteral nutrition HAVE to be administered?

Answer 18

via infusion pump through a central line with a filter

Question 19

What should you never do while administering TPN?

Answer 19

Abruptly stop the infusion or change the rate
if it is emergent or another bag of TPN is not ready, then replace it with IV dextrose

Question 20

When should you discard TPN and why?

Answer 20

after 24 hours to prevent microbial growth because of the high glucose content

Question 21

What assessments should be performed by the nurse when administering TPN?

Answer 21

VS every 4 hours
monitor blood & urine glucose every 6 hours

Question 22

What are the metabolic complications of TPN?

Answer 22

hyperglycemia
Hypoglycemia
Vitamin deficiencies

Question 23

What are the nursing actions for metabolic complications of TPN?

Answer 23

draw labs daily
replace fluids
glucose checks

Question 24

What are the nursing actions for an air embolism from TPN?

Answer 24

prime tubing
clamp cath & lay on left side in Trendelenburg to trap air
admin O2

Question 25

What are the nursing actions for an infection from TPN?

Answer 25

monitor for signs of infection
change dressing every 48-72 hours by surgical asepsis
change tubing every 24 hours
do not give any other meds through the line