Exam 3

Question 1

What is enteral nutrition?

Answer 1

This is when children cannot consume food via their mouth so nutrition must be delivered directly into theirGI tract.

Question 2

When is enteral nutrition recommended?

Answer 2

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

Question 3

In which instances would enteral nutrition not be recommended?

Answer 3

In either mechanical obstruction, non-mechanical obstruction or necrotizing enterocolitis.

Question 4

What is mechanical obstruction?

Answer 4

This is bowel obstruction that can happen due to adhesions, foreign bodies, gallstones, tumors, etc.

Question 5

What is non mechanical obstruction?

Answer 5

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

Question 6

What is necrotizing enterocolitis?

Answer 6

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.

Question 7

Who is at risk for necrotizing enterocolitis?

Answer 7

premature infants, formula fed infants, blood transfusion, etc

Question 8

When did tube feeding begin?

Answer 8

In ancient Egyptians, they performed this procedure to treat some diseases

Question 9

What are the 6 main categories of enteral feeding

Answer 9

Nasogastric 
Nasoduodenal 
Nasojejunal 
Orogastric
Gastrostomy 
Jejunostomy

Question 10

What are the nasotubes and their functions?

Answer 10

Nasogastric: through the nose to the stomach
Nasoduodenal: through the nose to the duodenum
Nasojejunal: through the nose to the jejunum

Question 11

When are nasal tubes appropriate?

Answer 11

They are appropriate for patients who rely on it temporarily (4-6 weeks)

Question 12

What are orogastric tubes?

Answer 12

These are similar to nasal tubes but it is for babies who breathe through their nose.

Question 13

What are gastrostomy tubes?

Answer 13

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

Question 14

What are jejunostomy tubes?

Answer 14

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

Question 15

What is enteral formula?

Answer 15

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

Question 16

What are stage 2 formulas?

Answer 16

These are formulas that are more advanced and are recommended for children over 9 months of age

Question 17

What are pediatric enteral formulas?

Answer 17

They are specialized formulas made for enteral feeding. Pediasure is the most common brand for this.

Question 18

Whatare blenderized formulas?

Answer 18

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.

Question 19

What are the disadvantages to blenderized formulas?

Answer 19

Viscosity can be too thick
high bacteria count, increase risk for infection
may not be complete nutrition

Question 20

What are some advantages to blenderized formulas?

Answer 20

It gives parents more options and lets them have control
Improves constipation and reflux
it consists of real and whole foods

Question 21

What are the modes of enteral feeding?

Answer 21

Intermittent Bolus
Continuous Feeds
Pump Feeding
Syringe Feeding

Question 22

What is intermittent bolus?

Answer 22

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

Question 23

What is continous feeding?

Answer 23

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

Question 24

What is pump feeding?

Answer 24

This can be used with both continous feeding and intermittent bolus feeding to control the rate at which food enters.

Question 25

How do we successfully transition to oral diet?

Answer 25

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