Eternal and parenteral nutrition

Question 1

What is meant by enteral nutrition?

Answer 1

Nutrition administered via the GI tract

Question 2

Who needs enteral nutrition?

Answer 2

Patients with eating and swallowing difficulties - e.g. facial injury or surgery
Severe intestinal malabsorption - Crohn’s disease
Eating disorders
Self-neglect - intentional or non-intentional

Question 3

What are the different routes of administration for enteral nutrition?

Answer 3

Oral - sip feeds
Naso-gastric tubes (NG)
PEG tubes
PEJ tubes

Question 4

What are some problems that can occur as a result of enteral nutrition?

Answer 4

Diarrhoea
Regurgitation
Dislocation of tube, especially NG

Question 5

Which drugs interact directly with enteral feeds?

Answer 5

Ciprofloxacin
Theophylline
Phenytoin

Question 6

When should total parenteral nutrition be used?

Answer 6

Only when EN is not an option
When patient cannot take anything by mouth or via GIT
In “gut failure” - patient unable to digest and absorb food

Question 7

How can short-term TPN be given?

Answer 7

via venflon

Question 8

How can long-term TPN be given?

Answer 8

peripherally inserted catheter - Hickman line

Via central line - intrajugular, subclavian, femoral

Question 9

How is re-feeding syndrome characterised?

Answer 9

Abnormalities in fluid balance, glucose metabolism, vitamin deficiency, hypokalaemia