Nutrition and Medication Administration in the Critically Ill

Question 1

What kind of state are ICU patients in?

Answer 1

Catabolic state

Question 2

What is the foundational building source of all tissue and the source of the amino acid pool?

Answer 2

Protein

Question 3

Which critically ill patient is at highest risk for malnutrition?

Answer 3

acute kidney injury patients

Question 4

What are 5 reasons that older adults have issues with protein synthesis?

Answer 4

decreased ability to participate in protein synthesis, reduced postprandial availability of amino acids, age-related decline in insulin sensitivity, decreased capacity to engage in resistance training, chronic low-grade inflmmation

Question 5

What are the 6 clinical characteristics of malnutrition?

Answer 5

insufficient food intake, weight loss over time, loss of fat mass, fluid accumulation, loss of muscle mass, and loss of strength

Question 6

What percentage of the immune system is in the gut?

Answer 6

70%

Question 7

How many clinical characteristics of malnutrition does a patient need to display to receive the diagnosis of malnutrition?

Answer 7

2

Question 8

What does enteral nutrition help maintain?

Answer 8

the integrity of the mucosal layer of the gut

Question 9

What are reasons that gut permeability may be increased as a part of the inflammatory response to illness/infection?

Answer 9

critical illness, malnutrition, and starvation

Question 10

Where is a Salem sump placed?

Answer 10

pre-pyloric

Question 11

What are the two types of pre-pyloric feedings?

Answer 11

salem sump and gastrostomy with enFit connectors

Question 12

What are the 3 types of post-pyloric feeding tubes?

Answer 12

Dobhoff/Corpak, Enteral tube fasteners, and Unfit Lopez valve/multiuse connector

Question 13

How long should a Salem sump be used?

Answer 13

2-4 weeks as a short term use

Question 14

What are the three ports for on a Gastrostomy with enFit connector?

Answer 14

water and meds, tube feeding, and air

Question 15

How long can a gastrostomy tube be used?

Answer 15

long-term

Question 16

What are 2 drugs that promote gastric emptying?

Answer 16

Metoclopramide and Erythromycin

Question 17

What are complications associated with enteral feeding?

Answer 17

sinusitis, VAP, misplacement into trachea or perforation, diarrhea, metabolic complications, refeeding sydrome

Question 18

What kind of line do you need for parenteral nutrition?

Answer 18

central line

Question 19

What are the complications of parenteral nutrition?

Answer 19

anemia, infection, high sugars, essential fatty acid deficiency

Question 20

How much water do you flush with when administering a med by enteral feeding? when is this done? what kind of water is used?

Answer 20

30-60mL, before and after med administration, using tepid water

Question 21

What should the bedside assessment of a patient that is on enteral nutrition include?

Answer 21

assess for complications, such as: abdominal distention, breathing discomfort, hyperglycemia, constipation, diarrhea, pt c/o discomfort or bloating, weight loss, and/or localized infection