Final Exam Review: Review Enteral/Parenteral Notes

Question 1

What are the two major routes of nutrition administration?

Answer 1

Enteral and Parental

Question 2

Enteral Feeding Types

Answer 2

Oral or PO diet (PO means by mouth), PO diet with nutritional supplementation, Tube feeding

Question 3

Liquid Diet types

Answer 3

Oral or PO diet; 1) Clear Diet: (minimal digestion and stimulation of the GI tract), Used before or after surgery, juices 2) Full Liquid Diet: Transition between clear liquids and solid food, transition is met with some discomfort (lactose, osmolality change)

Question 4

PO Diet with Supplements (Purpose, Challenge, Examples)

Answer 4

Type of Enteral Nutrition Type: Purpose - increasing nutrient density by adding calories and/or protein; Challenge - timing supplements with meals so that they really are supplements Examples: Liquid meal replacement formulas (Ensure, boost) or high energy/protein bars

Question 5

Types of Tube Feedings

Answer 5

Gastric: NG (Nasogastric), Gastrostomy; or Small Intestine: Nasojejunal (NJT), Nasoduodenal (NDT), or jejunostomy

Question 6

Which type of MNT is better? Enteral Nutrition or Parenteral Nutrition

Answer 6

Enteral Nutrition.

Question 7

Benefits of Enteral Nutrition (Most important)

Answer 7

1) Absorption of nutrients by the portal system 2) Maintains gut integrity 3) Maintains Gut Associated Lymphoid Tissue (GALT) 4) May protect against the translocation of bacteria into systemic circulation

Question 8

How does Enteral nutrition therapy maintain gut integrity and GALT?

Answer 8

Promotes mucosal cell turnover and renewal, whereas parenteral nutrition promotes mucosal and villous atrophy. Maintenance also is required for GALT structure and function

Question 9

Other benefits of Enteral nutrition

Answer 9

1) wound healing 2) immunological function 3) hyperglycemia 4) More convenient less expensive

Question 10

Considerations for tube feeding

Answer 10

route of administration, administration technique, product selection

Question 11

Routes of administration

Answer 11

Nasoenteric (gastric and intestinal) ; and gastric/duodenal/jejunual

Question 12

Determination of route

Answer 12

1) Length of MNT 2) Aspiration Risk 3) Patient’s digestion and absorption status 4) If surgery is planned 5) Formula viscosity and volume

Question 13

Benefits of feeding into the stomach

Answer 13

1) Able to accept high osmotic loads w/o cramping, distension, vomiting, diarrhea, or fluid/electrolyte shifts 2) Large reservoir capacity and readily accepts intermittent/bolus feedings

Question 14

Benefits of feeding into the small intestine

Answer 14

Less risk of aspiration

Question 15

Benefits of feeding beyond ligament of trietz

Answer 15

Lowest risk of aspiration

Question 16

Complications of nasoenteric tubes

Answer 16

1) Sore throat 2) Pressure necrosis 3) Sinusitis 4) Mucosal ulceration 5) Abscess formation 6) Perforation

Question 17

Tube Feeding Syndrome

Answer 17

hyperosmolar/non-ketoic dehydration; need to monitor patient’s hydration status

Question 18

Lab tests for tube feeding syndrome

Answer 18

1 ) Monitor for hypophosphatemia, hypokalemia, hypomagnesemia, fluid overload, congestive heart failure, and hyperglycemia 2) Initial PN infusion should aim to meet 75-100% of BEE (not total energy needs) and be advanced slowly 3) Electrolytes and minerals administered as needed