Nutritional support measures

Question 1

Oral supplements

Answer 1

• Supplementation for inadequate intake of food

- Supplements can be made to meet missing intake- fiber, protein, CA

Question 2

Tube feeding

Answer 2

• Increased risk of aspiration
• Must have fxn GI tract
• Supplementation for inadequate oral intake
• Must facilitate passage through pyloris

Question 3

Tube enterostomy

Answer 3

• Long term nutritional support
• Tube into GI tract
• Must have fxn GI tract
• At risk of aspiration

Question 4

Parenteral nutrition

Answer 4

• Nonfxn GI tract
• Via central vein- subclavian
• longer term

Question 5

Peripheral vein nutrition

Answer 5

• IV catheter into SVC
• Complete short term nutritional support
• Verify via CXR

Question 6

Complications of enteral support

Answer 6

• Diarrhea, emesis, esophagitis & GI bleed
• Mechanical aspiration
• Hypernatremic dehydration

Question 7

Complications of parenteral support

Answer 7

• Catheter related: sepsis, thrombosis, pneumothorax, hemothorax and arterial laceration
• Hyperglycemia, hypo nutrients

Question 8

Dumping syndrome- sx

Answer 8

• Early: 15-30 min post meals
• Crampy abd pain, N, diarrhea, belching, diaphoresis
• Late 90min-3 hrs post meals
• Lightheaded, diaphoresis, palpitations, syncope

Question 9

Dumping syndrome- Eti

Answer 9

• Impaired ability of stomach to regulate rate of emptying- surgery
• CV or GI symptoms

Question 10

Refeeding syndrome- Eti

Answer 10

• Rapid increase in caloric intake causing increased insulin secretion & decreased serum phosphorus & potassium

Question 11

Refeeding syndrome- Sx

Answer 11

• Hypophosphatemia

- Edema, third spacing, hyperglycemia, encephalopathy