Feedings

Question 1

What are enteral feedings?

Answer 1

Enteral feedings (still using the gut)

Question 2

Administering enteral feedings via an NG-tube, the nurse should

Answer 2

keep the HOB elevated at 45degrees for an hour after feeding to reduce the risk of aspiration.

Question 3

laboratory values to monitor for patients requiring continuous enteral feeding

Answer 3

Electrolyte levels, glucose levels

Question 4

What should you do when providing enteral feeding and residuals exceed 250 mL for two consecutive assessments?

Answer 4

Withhold the feeding.
Notify the provider.
Maintain semi-Fowler’s position.
Recheck residual in 1 hr.

Question 5

What should you do when providing enteral feeding and your pt has N/V?

Answer 5

Withhold the feeding. Turn the client to the side.
Notify the provider.
Check the tube’s patency.
Aspirate for residual.
Auscultate for bowel sounds.
Obtain a chest x-ray.

Question 6

Do Enteral clients eat food?

Answer 6

functioning GI tract but unable to swallow or take in calories/protein orally

Question 7

Examples of enteral feeding

Answer 7

Nasogastric tube (NG tube)
▪ Gastrostomy tube (G-Tube)
▪ Jejunostomy Tube (J-Tube)

Question 8

Total parentral feedings are tested for what?

Answer 8

Prealbumin levels-normal levels should be at: 15-36

Question 9

What is given in TPN?

Answer 9

amino acids, dextrose, electrolytes, vitamins, sterile water, fats

Question 10

Desired outcomes of TPN

Answer 10

Improved nutrition
weight maintenance
nitrogen balance

Question 11

How do you assess improved TPN status?

Answer 11

Daily weight 1kg per day
increases of pre albumin 15-36
increased urea nitrogen levels 10-20

Question 12

How do you prep client for PN?

Answer 12

client’s weight
BMI
nutritional status
diagnostics
labs
include: CBC, blood chem profile PT/aPTT
needs glucose platelet ct.
education
electronic infusion
micron filter

Question 13

What do you ask the client what he’s allergic to?

Answer 13

soybeans, safflower, eggs (if lipids are prescribed)

Question 14

What do you (nurse) monitor when administering?

Answer 14

blood glucose
flow rate
cracking of TPN solution (calcium phosphate content is too high)
Verify w-2nd nurse

Question 15

How long do you wait between taking PN out of refrigerator?

Answer 15

1 hr

Question 16

Technique

Answer 16

Strict aseptic technique-reduces infection risk sterile technique when changing central line and tubing

Question 17

Change the bag of IV tubing for dextrose solution how often?

Answer 17

every 24 hrs.

Question 18

How often do you change intermittent IV lipid infusions?

Answer 18

Should not hang for more than 12 hrs microbial growth prevention

Question 19

Lipid infusions need to be stopped how many hr prior to getting a blood specimen?

Answer 19

12 hrs. for accurate triglycerides

Question 20

How should you discontinue?

Answer 20

SLOWLY!!

Question 21

why should you give enteral substance during long term PN administration?

Answer 21

Diluted juice example to prevent atrophy of GI tract

Question 22

TPN vs. PPN

Answer 22

TPN: intense nutritional support for extended time
PPN: unable to consume enough calories to meet metabolic need or when nutritional support is needed for a short time

Question 23

TPN patient examples

Answer 23

Cancer, bowel disorders, critically ill, trauma, excessive burns, need for high caloric requirements