Midterm Study Guide Part 1 Flashcards
NG/OG (nasogastric/orogastric)
-Short term (< 4-6 weeks)
-OGT if risk of sinusitis
-Not for high aspiration risk
Nasoduodenal/Nasojejunal/ Oroduodenal/Orojejunal
-Post-pyloric placement
-Used for pt with high aspiration risk
Which are the “permanent” tubes?
-Percutaneous endoscopic gastrostomy (PEG)
-Percutaneous endoscopic jejunostomy (PEJ)
EN Indicators
-Inadequate oral intake
-Oral route unavailable but functional GI tract
-Severe wasting or depressed growth
-Impaired digestion, absorption, metabolism (possibly)
EN Contraindications
-Oral intake 75% of nutritional needs
-Peritonitis
-Intestinal obstruction
-Poor prognosis
EN Complications
-Residuals
-Diarrhea
-Aspiration pneumonia
-Dehydration
PN Indications
-Failed EN w/ post-pyloric tube
-Intestinal tract has severely diminished function
-Patient not expected to tolerate enteral feeding for at least 5-10 days
-TPN not indicated if expected to be needed <7 days
Catheter-related TPN Complications
– Pneumothorax
– Air embolism
– Venous thrombosis
– Improper tip location
– Phlebitis
– Catheter occlusion
– Catheter-related sepsis
Gastrointestinal TPN Complications
– Steatosis
– Cholestasis
– GI atrophy
– Gastric hyperacidity
Steatosis
-Fatty liver
-May be due to overfeeding or excess glucose
Refeeding syndrome
Metabolic and functional changes that may occur when malnourished patients are refed orally, enterally or parenterally
Glucose target lab values for critically ill patients
-140 - 180 mg/dl
-110-140 mg/dl may be acceptable for some patients
These lab values are decreased with inflammation
-Serum albumin
-Serum prealbumin
-Serum transferrin
-Platelet count
These lab values are elevated with inflammation
-C-reactive protein
-Blood Glucose
-% neutrophils in the cell differential
Thirst mechanism
Triggered by the hypothalamus when there is a lack of fluid or an increased concentration of certain osmolites
