Fluids And Nutrition

Question 1

Feeding NG tube:

Indications

Answer 1

Provides enteral nutrition eg.--
Malnutrition
Coma/ITU
Long term feeding
Catabolic eg sepsis, burns
Dysphagia from stricture or stroke

Question 2

NG tube:

Complications

Answer 2

Tube itself:
Nasal trauma
Malposition in airway or cranium
Blockage

Feeding:
Refeeding syndrome
Electrolyte imbalance
Feed intolerance–> diarrhoea

Question 3

Types of enteral nutrition

Answer 3

Oral supplements
Polymeric eg osmolite, jevity: contains intact proteins, starches and fatty acids
Disease specific eg for hepatic encephalopathy reduced AA
Elemental eg for Crohns. Require minimal digestion and used if abnormal GIT

Question 4

Parenteral nutrition:

Indications

Answer 4

Unable to swallow

Prolonged obstruction or ileus (>7days)
High output fistula
Short bowel syndrome
Severe malnutrition
Severe Crohns

Question 5

TPN:

Complications

Answer 5

Line related:
Pneumo/haemothorax
Cardiac arrhythmia
Line sepsis
Central venous thrombosis

Feed related:
Villus atrophy of GIT
Electrolyte disturbances
Hyperglycaemia and reactive hypoglycaemia
Vitamin and mineral deficiencies

Question 6

Refeeding syndrome:

What?

Answer 6

Life threatening metabolic complication of refereeing via any route after a prolonged period of starvation

Question 7

Patients at risk from Refeeding Syndrome

Answer 7

Malignancy
Anorexia nervosa
Alcoholism
GI surgery
Starvation

Question 8

Ryles nasogastric tube:

Indications

Answer 8

Draining of the stomach

Drip and suck management for bowel obstruction

Patients with persistent vomiting eg pancreatitis

Question 9

Types of synthetic Colloid (4)

Answer 9

Gelofusin
Volplex
Haemaccel
Voluven

Question 10

Types of natural Colloid

Answer 10

Albumin

Blood

Question 11

Uses of Colloid fluids

Answer 11

Fluid challenge
Hypovolaemic shock
Burns: Muir and Barclay

Question 12

Complications of Colloid use

Answer 12

Anaphylaxis

Volume overload