Specialized Nutrition Support Flashcards
When should enteral feeding be started during hospital admission?
within first 24 to 48 hours
with intent of reaching a goal within next 2-3 days
What do we do in setting of hemodynamic compromise?
withhold nutrition until patient is fully recuscitated and/or stable
True or false: The presence or absence of bowel sounds or evidence of passage of flatus and stool is not required for the initiation of enteral feeding
true
Indications for enteral feeding
- poor voluntary intake
- neurological impairment
- oropharyngeal impairment
- short gut syndrome
- major trauma, burns
If early enteral utrition is not feasible or available in the first 7 days of admission to the ICU, what do we do?
no nutrition support therapy should be provided
When should we initiate parenteral nutrition in a healthy well nourished individual prior to critical illness?
only after the first 7 days of hospitalization when EN is not available
When would you initiate PN ASAP?
if there is evidence of protein calorie malnutrition on admission and EN is now feasible
In terms of length of nutrition needs, discuss whether PN or EN is better?
short term (5-7) days, PN has no benefit and increased risk
PN should only be initiated if the duration of therapy is anticipated to be greater than 7 days
Indications for parenteral feeding
- unable to consume adequate amounts of nutrients for 5-10 days
- malabsorption
- ileus
- pseudo-obstruction
- small bowel or colonic obstruction
- high output GI fistula
- mucositis. espohagitis
- preggars vomitting
What is an NG tube?
nasogastric tube. nose to stomach
What is a NJ tube?
nasojejunal tube. nose to jejunum
What is a PEG tube
Percutaneous endoscopic gastrostomy tube. used instead of naso tubes if theres obstruction of upper GI or airway tracts.
tube crosses skin over stomach and is placed endoscopically
what is a PEJ tube
jejunal tube, cyclic or continuous. Like PEG,enters jejunum from skin
What is in parenteral nutrition?
formula: dextrose lipids amino acids electrolytes minerals vitamins trace elements
What is peripheral parenteral nutrition?
vein is accessed peripherally. Only if veins are adequate and feeding is TEMPORARY (aka patient is not critically ill or fluid restricted
