Lecture 2

Question 1

What are the reasons for enteric feeding?

Answer 1

Functional GI tract
Anoxic encephalopathy
Neurological disorders
OED
Tumours
Trauma
Patients with a altered oral intake for whatever reason

Question 2

Reasons for parenteral nutrition

Answer 2

Unable to eat or absorb through the GI tract
Severe gut dysfunction
7 able to to,era5e enteral feedings
Patients with disorders that necessitate complete bowel rest
Pre-term infants, congenital abnormalities

Question 3

What are the risks associated with increased volume of fluid to reach adequate calories?

Answer 3

Fluid overload
Increasing glucose concentration -risk of damaging blood vessels used

Question 4

Name the 2 types pf PN

Answer 4

TPN (Total Parenteral Nutrition)
PPN (Partial Parenteral Nutrition)

Question 5

What monitoring is required?

Answer 5

Body weight, FBC, electrolytes, blood urea nitrogen (BUN)
Glucose intake/output, liver function tests (LFTs)

Question 6

What is considered as part of the parenteral nutrition regimen?

Answer 6

Fluid volume of regimen
Energy requirement
Nitrogen requirement proportion of fats, protein, carbohydrate
Type of IV access
Whether or not a standard regimen is available as a basis for therapy
Electrolyte and trace elements requirements

Question 7

When should fluid requirements be increased?

Answer 7

Fever
Fistulas
Vomiting
Diarrhoea
NASOGASTRIC (NG) suction
Unusual fluid losses from burns
S, stomas and wound drains

Question 8

When should fluid requirements be decreased in?

Answer 8

Renal failure
CHF
CIRRHOTIC ASCITES
Pulmonary disease

Question 9

How are the energy requirements in PN measured?

Answer 9

Calculated via sex, age, weight, height and clinical condition

Question 10

What possible reactions could occur?

Answer 10

Creaming and coalescence of a fat emulsion
Sugars and AAs might react to yellow or brown substances
Occurrence of precipitates of electrolytes
Non -preferred change in pH

Question 11

Define multiple bag chamber (MBC)

Answer 11

Plastic bag divided into 3 compartments
Each chamber either contains either lipid, carbohydrate or an AA formulation
Can mix contents to obtain a ready to use AIO NUTRITION mixture
Can add individual vitamins, electrolytes, or trace elements solution via a special port
Less personsonalised but provides much longer but once mixed should be used within 20 hours

Question 12

Why is cys excluded?

Answer 12

Cys is readily oxidised to the disulphide which can be reduced by conversion of ascorbic acid to dehydroascorbic acid