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CSO Exam 2025 > Nutrition Support > Flashcards

Nutrition Support Flashcards

1
Q

dIn which cancers is EN especially beneficial?

A

Head and neck, gastric, esophageal, and pancreatic cancers

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2
Q

What type of EN formula is appropriate for most people with cancer?

A

Standard polymeric formula

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3
Q

List short-term access (up to 4-6 weeks) feeding tubes.

A

NG, OG, NJ, OJ, nasoduodenal, oroduodenal

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4
Q

List long-term access (months to years) feeding tubes.

A

PEG, G-tube, PEG-J, PEJ, J-tube, low-profile buttonWh

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5
Q

Which type of feeding tube requires use of an infusion pump?

A

Jejunal feeding tubes

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6
Q

How much and how often is water recommended to maintain tube patency during continuous and intermittent tube feeding?

A

Continuous: at least 30 mL every 4 hours
Intermittent: at least 30 mL before and after each feed

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7
Q

What are some issues with the preparation of home blenderized tube feeds?

A
  • labor intensive
  • increased occurrence of clogged tube
  • uncertain nutritional value
  • food safety concerns
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8
Q

What is the most common G-tube complication?

A

Peristomal infection

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9
Q

What conditions increase the risk for refeeding syndrome?

A
  • chronic malnutrition
  • prolonged hypocaloric feeding or fasting
  • NPO for >7 days
  • chronic alcoholism
  • anorexia nervosa
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10
Q

What are characteristics of standard (polymeric) formulas?

A
  • provided general nutrition needs
  • nutrient density varies from 1-2 kcal/mL
  • protein content varies from 14-25% of kcal
  • may contain fiber and prebiotics
  • ex: Nutren 1.5, Fibersource HN, Jevity 1.2, etc.
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11
Q

What are characteristics of semielemental (peptide-based) formulas?

A
  • for malabsorption, maldigestion, and feeding intolerance
  • nutrient density varies from 1-1.5 kcal/mL, some have higher MCT oil content
  • protein content ranges from 16-25% of kcal
  • may contain fiber, prebiotics, arginine, omega-3 FAs
  • ex: Peptamen 1.5, Vital AF 1.2, Impact Peptide 1.5, Kate Farms Peptide 1.5, etc.
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12
Q

What are characteristics of elemental (monomeric) formulas?

A
  • for severely compromised GI function
  • provides protein as 100% free amino acids
  • low fat, higher ratio of MCT oil
  • ex: Vivonex, Tolerex
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13
Q

What are characteristics of commercially available blenderized formulas?

A
  • formulated with real food ingredients
  • may contain more traditional ingredients
  • possibly suitable for those with food allergies
  • ex: Compleat Organic Blends, Liquid Hope, Real Food Blends, etc.
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14
Q

What are characteristics of EN formulas formulated for diabetes?

A
  • reduced carbohydrate content
  • may provide fiber
  • may be higher in fat and protein
  • ex: Glucerna 1.2, Diabetisource AC
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15
Q

What are characteristics of EN formulas formulated for renal disease?

A
  • reduced free water, Na, K, Phos, Ca
  • Contains 1.8-2 kcal/mL
  • protein content varies from 7-18% of kcal
  • ex: Nepro, Novasource Renal, Suplena
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16
Q

What are characteristics of EN formulas formulated for immune modulating?

A
  • may be higher in protein (peptide-based) and energy dense
  • may contain arginine, glutamine, EPA, DHA, elevated amounts of vitamin C and E and beta carotene
  • ex: Impact Peptide 1.5, Peptamen Intense VHP, Peptamen AF, Vital AF 1.2, Pivot 1.5
17
Q

What are characteristics of EN formulas formulated for pulmonary diseases?

A
  • reduced carbohydrate content, increase lipid content
  • nutrient density ~1.5 kcal/mL
  • protein content varies from 16-18% of kcal
  • may provide EPA, gamma-linoleic acid (GLA), and added antioxidants
  • ex: Pulmocare, Nutren Pulmonary
18
Q

How much thiamine should be supplemented to help prevent refeeding syndrome and for how long?

A

100 mg/day for 5-7 days

19
Q

State the feeding tube location, feed delivery time, initiation rate, advancement schedule and required equipment for syringe bolus feeds.

A
  • gastric tube
  • delivery ~15 min
  • initiation rate 60-120 mL
  • increase by 60-120 mL every 8-12 hrs (or every 1-2 feeds)
  • catheter tip syringe needed
20
Q

State the feeding tube location, feed delivery time, initiation rate, advancement schedule and required equipment for intermittent (or gravity) drip feeds.

A
  • gastric tube
  • delivery ~30-35 min
  • initiation rate 60-120 mL
  • increase by 60-120 mL every 8-12 hrs (or every 1-2 feeds)
  • gravity bags and pole needed
21
Q

State the feeding tube location, feed delivery time, initiation rate, advancement schedule and required equipment for cyclic feeds.

A
  • gastric or small intestine tube
  • often 12-18 hr infusion (<24 hrs)
  • initiation rate 10-40 mL/hr
  • increase by 10-20 mL/hr every 8-12 hrs
  • infusion pump with pole or backpack needed
22
Q

State the feeding tube location, feed delivery time, initiation rate, advancement schedule and required equipment for continuous feeds.

A
  • gastric or small intestine tube
  • 20-24 hr infusion
  • initiation rate 10-40 mL/hr
  • increase by 10-20 mL/hr every 4-24 hrs
  • infusion pump with pole or backpack needed
23
Q

True or False: Routine monitoring of gastric residual volumes (GRVs) for feeding intolerance is recommended.

A

False

Additionally, avoid holding EN for GRVs < 500 mL in the absence of other signs of intolerance

24
Q

What are some possible corrections to help with aspiration for a patient receiving EN?

A
  • elevate head of bead to 30-45 degrees
  • consider changing to post-pyloric tube
  • provide continuous feeds
  • consider adding prokinetic agent
  • consider changing to a concentrated formula at a lower rate
  • consider a fiber-free formula to enhance gastric emptying
25
Q

What does a patient need to have access to in order to have home EN?

A
  • running water for hand washing
  • electricity if using feeding pump
  • adequate storage for formula and supplies
26
Q

Which foundation provides community support, education, and outreach for patients receiving EN?

A

Oley Foundation

27
Q

True or False: EN feedings used to manage malnutrition or anorexia are covered under Medicare Part B.

A

False

28
Q

What are some oncology-specific indications for parenteral nutrition (PN)?

A
  • Paralytic or post-op ileus
  • Malignant bowel obstruction
  • High output (>200 mL/d) distal GI fistula
  • Inability to tolerate EN for 7-14 days
  • Large volume diarrhea or high-output ostomies refractory to medication management
29
Q

SMOFlipid should be avoided in patients with which food allergies or sensitivities?

A
  • Soybean
  • Fish
  • Egg
  • Peanut protein
30
Q

What are standard PN electrolyte requirements for adults (Na, K, Phos, Mg, Ca, Cl, acetate)

A
  • Na: 1-2 mEq/kg BW
  • K: 1-2 mEq/kg BW
  • Phos: 20-40 mmol
  • Mg: 8-20 mEq
  • Ca: 10-15 mEq
  • Cl: as needed to maintain acid-base balance
  • Acetate: as needed to maintain acid-base balance
31
Q

What medications can be added directly to PN solution if needed?

A
  • histamine H2-receptor antagonists (ex: Famotidine)
  • Insulin
  • Heparin
32
Q

For Medicare to cover PN, which conditions must be documented in the medical record?

A
  • Nonfunctional GI tract or failed EN trials
  • At least 90-day need for PN therapy
33
Q
A

CSO Exam 2025 (25 decks)

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