Nutrition and Medication Administration in the Critically Ill Flashcards
What kind of state are ICU patients in?
Catabolic state
What is the foundational building source of all tissue and the source of the amino acid pool?
Protein
Which critically ill patient is at highest risk for malnutrition?
acute kidney injury patients
What are 5 reasons that older adults have issues with protein synthesis?
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
What are the 6 clinical characteristics of malnutrition?
insufficient food intake, weight loss over time, loss of fat mass, fluid accumulation, loss of muscle mass, and loss of strength
What percentage of the immune system is in the gut?
70%
How many clinical characteristics of malnutrition does a patient need to display to receive the diagnosis of malnutrition?
2
What does enteral nutrition help maintain?
the integrity of the mucosal layer of the gut
What are reasons that gut permeability may be increased as a part of the inflammatory response to illness/infection?
critical illness, malnutrition, and starvation
Where is a Salem sump placed?
pre-pyloric
What are the two types of pre-pyloric feedings?
salem sump and gastrostomy with enFit connectors
What are the 3 types of post-pyloric feeding tubes?
Dobhoff/Corpak, Enteral tube fasteners, and Unfit Lopez valve/multiuse connector
How long should a Salem sump be used?
2-4 weeks as a short term use
What are the three ports for on a Gastrostomy with enFit connector?
water and meds, tube feeding, and air
How long can a gastrostomy tube be used?
long-term
What are 2 drugs that promote gastric emptying?
Metoclopramide and Erythromycin
What are complications associated with enteral feeding?
sinusitis, VAP, misplacement into trachea or perforation, diarrhea, metabolic complications, refeeding sydrome
What kind of line do you need for parenteral nutrition?
central line
What are the complications of parenteral nutrition?
anemia, infection, high sugars, essential fatty acid deficiency
How much water do you flush with when administering a med by enteral feeding? when is this done? what kind of water is used?
30-60mL, before and after med administration, using tepid water
What should the bedside assessment of a patient that is on enteral nutrition include?
assess for complications, such as: abdominal distention, breathing discomfort, hyperglycemia, constipation, diarrhea, pt c/o discomfort or bloating, weight loss, and/or localized infection
