Complex Exam 3 - acute nutritional support Flashcards

1
Q

What should be done before an initial enteral feeding?

A

abdominal x-ray

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2
Q

How long should you listen to bowel sounds in each quadrant with enteral feedings?

A

1 full minute in each

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3
Q

How can the stability of an enteral feeding tube be assessed?

A

by looking at the marker outside of the tube

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4
Q

How long should glucose checks be done for enteral feedings?

A

for the first 24 hours

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5
Q

What should the head of the bed be raised to during feedings?

A

30-45

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6
Q

Should feedings be left on when the patient is supine?

A

NO

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7
Q

When should an enteral feeding tube be flushed?

A
  • before and after feedings
  • q 4-6 h
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8
Q

How can enteral feedings cause diarrhea?

A

incorrect concentration of feedings

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9
Q

How can diarrhea from enteral feedings be treated?

A

by increasing fiber and fluids

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10
Q

What can enteral tube displacement cause?

A

aspiration pneumonia

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11
Q

If a patient is experiencing aspiration pneumonia, what should be done?

A
  • STOP feeding
  • suction with patient on side
  • provide O2
  • auscultate breath sounds
  • get a CXR
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12
Q

What VS increase should be monitored with aspiration pneumonia?

A

temperature

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13
Q

When should enteral tube patency be checked?

A
  • q 4 h
  • before and after feedings
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14
Q

How often should enteral tube placement be checked?

A

q shift

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15
Q

How can you tell if the enteral tube is in the stomach (gastrostomy)?

A

pH <4

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16
Q

How can you tell if the enteral tube is in the jejunum (jejunostomy)?

A

pH >6

17
Q

What is parenteral nutrition composed of?

A
  • amino acids (protein)
  • dextrose
  • electrolytes
  • minerals
  • vitamins
  • possibly fat emulsions
18
Q

How is parenteral nutrition administered?

A

via infusion pump

19
Q

What must be present in the tubing to collect particles from the parenteral solution?

A

a filter

20
Q

What should be used if TPN runs out since it can never stop abruptly?

A

dextrose 10% in water

21
Q

If on TPN feedings, how are labs drawn and fluids given?

A

with another IV site

22
Q

What metabolic complications are TPN patients at risk for?

A
  • hyper/hypoglycemia
  • vitamin deficiencies
23
Q

When does an air embolism occur?

A

during tubing changes

24
Q

What should be done for air embolism?

A
  • prime tubing
  • clamp catheter
  • lay on left side in trendelenburg
  • admin O2
25
Q

What can cause infection with parenteral feedings?

A

bacterial growth from concentrated glucose

26
Q

How often should a CVL dressing be changed?

A

q 48-72 hours

27
Q

How often should parenteral tubing be changed?

A

q 24 hours