Lecture 3

Question 1

how to assess diet intake in hospitalized pt?

Answer 1

CMTF visual tools, pt history prior to admission (eg. on ONS or special diets), calorie counts, families (bringing in food to pt), recall

Question 2

oral feeding strategies to increase intake

Answer 2

likes/dislikes, timing of meals, adding in snacks, food fortification (increase nutr density), oral nutrition supplements

Question 3

advantages of ONS:

Answer 3

nutrient dense, incrase calorie/protein intake, promote wt gain, convenient

Question 4

disadvantages of ONS:

Answer 4

tolerance pt dependent, limited evidence to support changes in relevant outcomes, cost

Question 5

MedPass program involves:

Answer 5

resource 2.0, small volumes of high cal/pro ONS with meds

Question 6

what is protected mealtime?

Answer 6

only eat during meals, no testing/interruptions

Question 7

what does distal mean?

Answer 7

“to stand away from”

Question 8

common conditions where EN might be implicated:

Answer 8

resp failure requiring ventilatory support (hypermetabolic), disorders impacting swallowing, GI disease, insufficient intake

Question 9

why use EN instead of PN?

Answer 9

maintains functional integrity of gut, maintains normal gallbladder fxn, help maintains gut-associated lymphoid tissue, improved clinical outcomes, less expensive

Question 10

contraindications for EN

Answer 10

insufficient GI absorptive capacity (diarrhea), mechanical obstruction of the GIT, paralytic ileus, severe GI bleed, distal high output fistula, intractable vomiting/diarrhea that doesn’t improve with med mgmt, GI tract can’t be accessed, aggressive nutr intervention not warranted

Question 11

types of enteral tube feeding:

Answer 11

NG, orogastric, nasoduodenal, nasojejunal, gastrostomy tube, gastrojejunostomy, jejunostomy

Question 12

factors influencing EN access:

Answer 12

expected duration of EN therapy, clinical factors, modality of feeding, desired location, available expertise and resources