Enteral/parenteral nutrtion

Question 1

What is enteral feeding?

Answer 1

Using some form of tube to enter the gastrointestinal tract at a level that is working. Delivery of a liquid diet whilst areas of the gastrointestinal tract are healing.

Question 2

What is parenteral feeding?

Answer 2

This is where pharmacologically designed product is given via an intravenous route bypassing the normal routes of eating and digestion. This type of diet is a mixture of proteins, fats and carbohydrates in simple form.

Question 3

Why do we need assisted feeding?

Answer 3

The animal is unable to eat as it normally would or is unable to absorb nutrition from specific sections of its GI tract.

Question 4

What are the different possible feeding tube routes for assisted feeding?

Answer 4

Syringe feeding
Naso-oesophageal, naso-gastric
Oesophagostomy
Gastrostomy/PEG
Enterostomy

Question 5

What foods can we use for assisted feeding?

Answer 5

Liquid or mixed diets
Specific clinical diets, can be diluted down to help.
Critical care diets

Question 6

How do we calculate the amount of feed needed to be given during assisted feeding?

Answer 6

Question 7

What are the common problems with feeding tubes and their causes?

Answer 7

Blockages
Coughing, sneezing, vomiting, movement => Dislodging of the tube
Chewing, biting and pawing => Trauma
Poor care of surgical site => Infection
Movement, infection => Over-granulation

Question 8

Following repair to a simple fracture to the mandibular symphisis, Pumpkin will require 3 days of post operative nutritional support. What feeding method would you choose?

Answer 8

Naso-oesophageal
Easy to place and manage, good for short term up to 7 days and well tolerated.

Question 9

Pumpkin will need a feeding guide developing, she weighs 4.3kg. Work out her RER and how much to feed her if you are using RCW recovery liquid at 1.1 k/cal per 1ml liquid. Remember to think about how much per meal and how many meals per day.

Answer 9

RER 199kcal = 181ml/day
46ml/ml per meal (more volume, less frequent) or 23ml/meal (less volume, more frequent)

Question 10

At the first feeding session you begin by pushing 5 mls of water into the feeding tube and Pumpkin begins to cough. What could be the problem and what do you do?

Answer 10

Stop Feeding
Check positioning of the tube with X-rays
The tube could have moved into the trachea
the tube could have moved into the lungs
Dislodgment of the tube.
Potentially need to replace the tube with a new one