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Nutrition > Unit 9: Supplemental Nutrition > Flashcards

Unit 9: Supplemental Nutrition Flashcards

1
Q

Who benefits from vitamin supplements?

A

Those who routinely fail to obtain recommended amounts of vitamins and minerals from the diet (chronic dieters)
Those with special needs (pregnant, elderly)

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2
Q

Should people take a daily multivitamin supplement?

A

There is conflicting research. Some say it can benefit, others say there are no benefits unless you are deficient.

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3
Q

What percentage of Canadians regularly take vitamins, minerals, etc.?

A

71%

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4
Q

What are the vitamins, mineral, herbal products, etc. fall under and what are they regulated under?

A

They are known as Natural Health Products (NHPs) and are under the Natural Health Product Regulations that came into effect on Jan 1, 2004.

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5
Q

What are categorized as Natural Health Products (NHPs)?

A

Vitamins and minerals, herbal remedies, homeopathic medicines, chinese traditional medicines, probiotics and amino acids and essential fatty acids.

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6
Q

What must approved NHPs have on their bottle?

A

A Natural Product Number (NPN) or Drug Indentification Number-Homeopathic Medicine (DIN-HM)

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7
Q

What should you try before taking supplements?

A

Try to make changes to the diet to improve nutritional content and only take supplements when truly needed.

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8
Q

What is enteral nutrition?

A

Giving nutrients using the GI tract either orally or via tube feedings.

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9
Q

What is parenteral nutrition?

A

Giving nutrients intraveneously

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10
Q

What kind of nutrition should you use if the patient does not have a functional GI tract?

A

Parenteral.
Use peripheral vein for short term and not severely malnourished.
Use central vein for long term or severely malnourished.

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11
Q

What kind of nutrition should be used if the patient has a functional GI tract?

A

Oral diet if satisfactory appetite and physically able to eat.
Enteral by feeding tube if intake is inadequate.

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12
Q

When could an oral nutrient-fortified supplement be used?

A

If the patient is having difficulty maintaining an adequate food intake.

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13
Q

What are some examples of nutrient-fortified supplements?

A

BoostTM, EnsureTM, Life Brand, Equate

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14
Q

What are some forms that nutrient-fortified supplement can come in?

A

Shakes, pudding (BoostTM) and fruit beverage (BoostTM)

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15
Q

What are some types of fortified shakes?

A

High protein, extra calories, reduced carbohydrates, high fibre

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16
Q

Who are tube feedings used for?

A

Individuals who are unable to meet their nutrient needs orally, provided that the GI tract is functioning.

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17
Q

What is nasogastric tube feeding?

A

Tube is placed into the stomach via the nose.

For feedings less than 4 weeks

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18
Q

What is nasointestinal tube feeding?

A

Tube is placed into the small intestine via the nose
Nasduodenal and nasojejunal
For feedings less than 4 weeks

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19
Q

What is orogastric tube feeding?

A

The tube is inserted into the stomach through the mouth.

Often used in infants because nasogastric can inhibit breathing.

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20
Q

What is gastrostomy tube feeding?

A

An opening into the stomach through which a feeding tube can be passed.
Can create using a percutaneous endoscopic gastronomy

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21
Q

What is jejunostomy tube feeding?

A

An opening into the jejunum through which a feeding tube can be passed.
Can create using a percutaneous endoscopic jejunostomy
Can go directly into jejunum or via gastronomy

22
Q

What are standard enteral formulas?

A

Polymeric formulas for patients who can digest and absorb nutrients without difficulty. Contain intact proteins and carbohydrates.
Blenderized formulas can some from a mixture of whole foods.

23
Q

What are elemental enteral formulas?

A

For patients who have compromised digestive or absorptive functions.
Contain proteins and carbs which have been partially or fully broken down. Low in fat

24
Q

What are specialized enteral formulas?

A

Designed to meet the specific nutrient needs of patients with particular illnesses.
Expensive with controversial effectiveness.

25
Q

What are modular enteral formulas?

A

Created from individual single macronutrient preparations (modules) for patients who require specific nutrient combinations to treat their illnesses. Vitamin and mineral preparations are also included.

26
Q

What is an open feeding system?

A

The formula must be transferred from the original packaging to a feeding container before it is administered through the feeding tube.

27
Q

What is a closed feeding system?

A

The formula comes pre-packaged in a container that can be attached directly to the feeding tube.

28
Q

What are intermittent feedings?

A

Delivering relatively large amounts of formula several times per day (250-400 ml over 30-45 minutes)
Best tolerated, requires gravity drip or infusion pump, higher risk of aspiration, similar to usual pattern of eating

29
Q

What are continuous feedings?

A

Slowly delivering smaller amounts continuously during the day (8-24 hour)
Limit patient’s freedom of movement, easier to tolerate

30
Q

What are bolus feedings?

A

A rapid delivery of a large volume of formula. (250-500 ml over 5-15 minutes)
Doesn’t need an infusion pump, convenient for patients and staff, very high risk of aspiration, nausea, cramping, abdominal cramping

31
Q

When is parenteral nutrition contraindicated?

A

GI tract is functioning and accessible, treatment is less than 7 days, risks outweigh benefits, palliative care, patient not stable and unable to obtain venous access.

32
Q

How must parenteral solutions be different for peripheral veins?

A

Must be less concentrated to prevent damage, so higher volumes are needed.

33
Q

Where are peripherally inserted catheters inserted?

A

Enter circulation at the basilic or cephalic vein and are guided up to the heart so the tip rests in the superior vena cava

34
Q

Where are central catheters inserted?

A

Enter circulation at the right subclavian vein (can be left subclavian, internal jugular or external jugular) and are threaded into the superior vena cava so the tip rests close to the heart

35
Q

What are parenteral solutions comprised of?

A

Individualized and can change from day to day. Either 2 in 1 or 3 in 1 (total nutrient admixture-TNA)

36
Q

What does a 2 in 1 parenteral solution contain?

A

Dextrose and amino acids and a lipid emulsion which is administered separately.

37
Q

What does a 3 in 1 parenteral solution contain?

A

Dextrose, amino acids and lipids.

38
Q

What time period is parenteral nutrition administered?

A

Continuously (over a 24 hour period) or cyclic (over an 8 to 16 hour period)

39
Q

When can refeeding syndrome occur?

A

When feedings are overly aggressive for severely malnourished individuals.

40
Q

What are some symptoms of refeeding syndrome?

A

Fluid and electrolyte imbalances and hyperglycemia

41
Q

What is dysphagia?

A

The difficulty in swallowing. Affects food and beverage intake, mouth care, medication use, etc.
Requires a multidisciplinary team.

42
Q

What are some symptoms of dysphagia?

A

Drooling, choking or coughing during or after meals, pocketing food, absent gag reflex, inability to suck from straw, chronic URT infections, weight loss and gurgly voice quality.

43
Q

What is the difference between oropharyngeal and esophageal dysphagia?

A

Oropharyngeal inhibits the transfer of food from the mouth and pharynx to the esophagus.
Esophageal interferes with the passage of materials through the esophageal lumen and into the stomach

44
Q

What are some causes of dysphagia?

A

Oropharyngeal: Alzheimer’s, Lou Gehrig’s, MS, Cerebral palsy, Parkinson’s disease
Esophageal: Cancer, esophageal spasm, stritures, external compression

45
Q

What are some complications of dysphagia?

A

Aspiration, dehydration, loss of enjoyment for eating and weight loss. Can often lead to malnutrition

46
Q

What is the goal of nutrition interventions for dysphagia?

A

To ensure that the diet remains nutritionally adequate and palatable in a consistency safely tolerated by the patient.

47
Q

How can dysphagia be managed?

A

Altering food texture to make them easier to swallow and altering the viscosity of fluids

48
Q

How are the textures of food modified for dysphagia?

A

Mince, puree or blenderize food. Use foods that are naturally soft and form a cohesive bolus (macaroni casseroles, egg dishes, meat loaf). Add sauces and gravies. Mixed texture foods are often blended.

49
Q

How are the textures of fluids modified for dysphagia?

A

Thickened fluids are easier to swallow. Nectar thick fluids drip off a spoon and can be sipped through a straw. (tomato juice) Honey thick fluids are thicker than nectar and do not hold their shape on the spoon but can’t be sipped through the straw. (tomato straw)

50
Q

What is a concern when using thickened fluids?

A

Hydration

51
Q

What are some alternatives for patients with dysphagia?

A

Learning alternative feeding techniques such as as exercises to strengthen the tongue, new methods of swallowing or changing positioning.

Nutrition (9 decks)

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