Exam 3 Flashcards
What is enteral nutrition?
This is when children cannot consume food via their mouth so nutrition must be delivered directly into theirGI tract.
When is enteral nutrition recommended?
When the child has a condition that does not allow them to swallow food properly, they are recommended to take enteral nutrition. If this is recommended, the physician has to make sure that the child’s GI tract is fully functional and that there is enough length for absorption
In which instances would enteral nutrition not be recommended?
In either mechanical obstruction, non-mechanical obstruction or necrotizing enterocolitis.
What is mechanical obstruction?
This is bowel obstruction that can happen due to adhesions, foreign bodies, gallstones, tumors, etc.
What is non mechanical obstruction?
This is typically due to ileus (lack of peristalsis movement in the intestine). This can be caused by infection, decreased perfusion, complications of abdominal surgery
What is necrotizing enterocolitis?
This is when the intestinal lining is dying and this condition is common premature infants and some newborn. This is when the intestine of the infant is invaded by bacteria, it causes infection and destroys the lining.
Who is at risk for necrotizing enterocolitis?
premature infants, formula fed infants, blood transfusion, etc
When did tube feeding begin?
In ancient Egyptians, they performed this procedure to treat some diseases
What are the 6 main categories of enteral feeding
Nasogastric Nasoduodenal Nasojejunal Orogastric Gastrostomy Jejunostomy
What are the nasotubes and their functions?
Nasogastric: through the nose to the stomach
Nasoduodenal: through the nose to the duodenum
Nasojejunal: through the nose to the jejunum
When are nasal tubes appropriate?
They are appropriate for patients who rely on it temporarily (4-6 weeks)
What are orogastric tubes?
These are similar to nasal tubes but it is for babies who breathe through their nose.
What are gastrostomy tubes?
These tubes are created by making a small incision and inserting it directly into the stomach. This is typically for patients who will require it for more than 4-6 weeks.This mimics the real process of digestion and absorption more accurately than the others
What are jejunostomy tubes?
These are inserted directly on the jejunum but it is used when we want to prevent aspiration. In gastrostomy, the food can come up and go to the lungs
What is enteral formula?
This is what we feed the child and it can be breast mil or any other infant formula as long as it is mixed properly. We just have to make sure all the nutrient requirements are met
What are stage 2 formulas?
These are formulas that are more advanced and are recommended for children over 9 months of age
What are pediatric enteral formulas?
They are specialized formulas made for enteral feeding. Pediasure is the most common brand for this.
Whatare blenderized formulas?
This is a formula that is made from blending a variety of different foods. It consists a mixture of blenderized and strained real foods. These are very thick and are not receommended for nasogatric tubes because the tube is very small.
What are the disadvantages to blenderized formulas?
Viscosity can be too thick
high bacteria count, increase risk for infection
may not be complete nutrition
What are some advantages to blenderized formulas?
It gives parents more options and lets them have control
Improves constipation and reflux
it consists of real and whole foods
What are the modes of enteral feeding?
Intermittent Bolus
Continuous Feeds
Pump Feeding
Syringe Feeding
What is intermittent bolus?
The feeding is done at different times throughout the day and can only be done if the patient is awake because we use gravity to push the food down. This feeding mimics normal eating times
What is continous feeding?
Provides formula at a constant rate over several hours and can even be given overnight. In this method, there is basically no storage of food, it is constantly being absorbed and it requires feeding pump. The disadvantage is that this is very expensive
What is pump feeding?
This can be used with both continous feeding and intermittent bolus feeding to control the rate at which food enters.
How do we successfully transition to oral diet?
As a physician, we must keep in mind that the ultimate goal is that the child eats normally. We must reduce calories when transitioning to oral feedingby 25%. Tube feeding should mimic normal eating times and overall, as oral intake begins to increase, tube feeding should decrease
