part 2 Flashcards
Oral Nutrition – TEST MEALS
Measures fat globules in the stools to detect fat absorption as in cases like cystic fibrosis
FECAL FAT DETERMINATION TEST
FECAL FAT DETERMINATION TEST
Consists of
100g fat ingested daily for 3days prior to fecal collection
**2 cups whole milk, 1 egg, 8oz lean meat, 10 exchanges of fat
Oral Nutrition – TEST MEALS
Use to determine GIT bleeding
MEAT-FREE TEST
MEAT-FREE TEST
consist of
A 3-day diet excludes ingestion of meat, poultry, and fish
Oral Nutrition – TEST MEALS
Use to determine urinary calcium excretion to diagnose hypercalciuria
CALCIUM TEST
CALCIUM TEST
consist of
Requires 1,000mg calcium intake – 400mg from food sources and 600mg from oral supplements
Oral Nutrition – TEST MEALS
Use to detect calcinoid tumors of the intestinal tract
SEROTONIN
SEROTONIN
consist of
Food rich serotonin is excluded in the diet
Diet Therapy – NUTRITION
Intended for patients with a functioning GIT but unable to ingest the required nutrients orally
Enteral feeding
delivery of food and nutrients either ORALLY or BY TUBE directly into the GIT
Enteral feeding
Diet Therapy
Administered to those who are neuro-muscularly impaired and cannot chew or swallow food
ENTERAL NUTRITION
EN feeding or gavage feeding for an infant:
Too weak for sucking
lacks a gag reflex
To conserve energy when attempting to feed but cyanotic
ENTERAL NUTRITION
Consists of ___ administered by a tube into the stomach or small intestine
blenderized foods or commercial formula
Enteral Nutrition – FORMULAS/FEEDING TYPES
Ready-to-use
Tube
Standard
Blenderized
Enteral Nutrition – ENTERAL FORMULATION
READY-TO-USE
Can be used alone & provides the TOTAL needs in a specified volume of formula
Complete formulation
Enteral Nutrition – ENTERAL FORMULATION
READY-TO-USE
Provides the diff forms of individual nutrients to supplement existing formulas
Modular formulation
Enteral Nutrition – ENTERAL FORMULATION
READY-TO-USE
Meets the therapeutic needs
Combined formulation
Enteral Nutrition – ENTERAL FORMULATION
May be prepared from regular foods
TUBEFEEDINGS
Enteral Nutrition – ENTERAL FEEDING ROUTES|
SHORT-TERM
Nasogastric
Nasointestinal
Nasoduodenal / nasojejunal
Enteral Nutrition – ENTERAL FEEDING ROUTES|
LONG-TERM
Esophagostomy
Gastrostomy or percutaneous endoscopic gastrotomy 9PEG)
Jejunostomy or percutaneous endoscopic jejunostomy (PEJ)
EN feeding or _____ for aninfant too weak for sucking, lacks agag reflex & to conserve energy whenattempting to feed but cyanotic
gavage feeding
Types of Enteral Formulation
Nutritionally complete formulation can be used
alone and provides the total needs in a
specified volume of formula.
Ready-to-use Formulation
Types of Enteral Formulation
– This type of feeding may be
prepared from regular foods.
2.Tube Feedings –
Types of Enteral Formulation
– This type of feeding is
fiber-free and high in cholesterol, fat and sugar. It is
a milk-based formulation with sugar and soft
cooked eggs.
Standard Tube Feedings
Types of Enteral Formulation
– It consists of soft diet
allowances which can be blenderized easily. Plan for
Blenderized Formula:
4.Blenderized Tube Feeding
ENTERAL FEEDING ROUTES
1. Short-term Enteral Access
adv and disadvantage
Nasogastric
Rapid
placement
Feedings can
be
immediately
easily removed by patients
inadvertently inserted into trachea,
Anomalies in nose and neck
ENTERAL FEEDING ROUTES
1. Short-term Enteral Access
adv and disadvantage
Nasointestinal
Tubes
Placed by doctor or nurse ONLY WITHguidance of a fluoroscope or endoscope
-
trauma to the jaw, base of skull, or neck, especially in patients who have large esophageal varices
ENTERAL FEEDING ROUTES
1. Short-term Enteral Access
adv and disadvantage
Nasoduodenal
or nasojejunal
tubes
aspiration
may be reduced.
Dislodgment by
coughing or
vomiting = aspiration
ENTERAL FEEDING ROUTES
Long-term Enteral Access
adv and disadvantage
Esophagostomy
head and
neck cance
performed underlocal
anesthesia.
Feeding can begin
immediately
-
requires surgery andformationof a stoma
72 hours after surgery
excessive granulation
accidental dislodgement
Complication of Enteral Feeding \
Mechanical
Nasopharyngeal irritation
- ice chips, topical anesthetic, and decongestant
Complication of Enteral Feeding \
Mechanical
Luminal obstruction
– flush; replace
tube
Complication of Enteral Feeding \
Mechanical
Mucosal erosions
– reposition tube; ice
water lavage; remove tube
Complication of Enteral Feeding \
Mechanical
Tube displacement –
replace tube
Complication of Enteral Feeding \
Mechanical
Aspiration
– discontinue tube feeding
Complication of Enteral Feeding
Gastrointestinal
Cramping / Distention
– change
formula;reduce infusion rate
Complication of Enteral Feeding
Gastrointestinal
Vomiting / Diarrhea
– dilute formula;
reduce infusion rate; anti-diarrhea
agents
Complication of Enteral Feeding
Gastrointestinal
Constipation –
– promotesufficientfluidsand fibers; encourage patient activity
Complication of Enteral
Metabolic
Hypertonic dehydration
–increasefreewater
Complication of Enteral
Metabolic
Glucose intolerance
– reduceinfusionrate; give restriction
Complication of Enteral
Metabolic
Cardiac failure
– reducesodiumcontent; fluid restriction
Complication of Enteral
Metabolic
Renal failure
– decreasephosphate, magnesium, potassium, protein restriction, essential amino acid solution
Complication of Enteral
Metabolic
Hepatic encephalopathy
–decreaseamount of protein
Nasoduodenal
or nasojejunal
tubes
Nasoduodenal:
Tube extends from nose through the plylorus into
the duodenum;
peristalsis or videoflouroscopy
Nasojejunal:
nose
through pylorus
into the jejunum
and is usually
placed by
videoflouroscopy
Mostly for infants
and children at
risk for aspiration
and regurgitation
Gastrostomy or
Percutaneous
Endoscopic
Gastrotomy (PEG)
PEG: Tube is
percutaneously
placed in the
stomach under
endoscopic
guidance, secured
by robber “bumpers” or
inflated ballon
catheter
Gastrostomy: Tube
is passed through
incision in
abdominal wall into
the stomach.
Gastrostomy or
Percutaneous
Endoscopic
Gastrotomy (PEG)
Adv and Disadv
maximal
opportunity for
absorption;
natural delivery of
nutrients into the
stomach;
Eliminates nasal or
esophageal irritation
Tube is unobtrusive;
PEG feeding can be
started after approx.. 24 hours.
-
Jejunnostomy or
Pecutaneous
Endoscopic
Jejunostomy (PEJ)
Types include needle
catheter placement, direct tube placement, and creation of jejuna
stoma that is
catheterized
intermittentl
PEJ: weighted feeding
tube passes
endoscopically through
as trostomy tube
(from PEG insertion) into
the duodenum;
Peristaltic action
advances tube into the
jejunum.
Jejunnostomy or
Pecutaneous
Endoscopic
Jejunostomy (PEJ)
Adv and Disadv
Permit feeding in patients
with upper GI tract
obstruction, esophageal
reflex, ulcerated or
neoplastic disease of
stomach, impaired gastric
emptying;
early
postoperative feeding
possible (jejunum rapidly
resumes its function within
12-24 hours)
Surgical procedure is required. Ambulatory patients may findjejunal
feeding restrictive because of theneedforcontinuous infusion of formula.
