Unit 9 - Supplemental Nutrition Flashcards

1
Q

Who benefits from vitamin supplements?

A
  • Those who fail to obtain the recommended amounts of vitamins and minerals from their diet
  • Those w/ special needs
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2
Q

Who benefits from vitamin B12 supplements?

A
  • Vegetarians who eat all-plant diets

- Other adults w/ atrophic gastritis

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3
Q

What numbers are assigned to natural health products and what does this mean?

A
  • Assigned a Natural Product Number (NPN) or Drug Identification Number - Homeopathic Medicine (DIN-HM)
  • Means that product underwent and passed review of formulation, labelling, and instructions for use, so it is safe
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4
Q

What is enteral nutrition?

A

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

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5
Q

What is parenteral nutrition?

A

Giving nutrients intravenously

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6
Q

Which feeding method should be chosen for a patient that has adequate nutrition status?

A
  • Oral diet and have their nutrition status reassessed regularly
  • Can use a simple IV to maintain hydration if necessary
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7
Q

Which feeding method should be chosen for a patient that has a functional GI tract, satisfactory appetite, and is physically able to eat?

A

Oral diet

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8
Q

Which feeding method should be chosen for a patient that has a functional GI tract, but not a satisfactory appetite or is physically unable to eat?

A

Enteral nutrition

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9
Q

Which feeding method should be chosen for a patient that does not have a functional GI tract and short-term support is anticipated?

A

Parenteral nutrition by peripheral vein

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10
Q

Which feeding method should be chosen for a patient that does not have a functional GI tract and long-term support is anticipated or they are severely malnourished?

A

Parenteral nutrition by central vein

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11
Q

When should tube feedings be used?

A

If an individual is unable to meet their nutrient needs orally, but must have a functioning GI tract

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12
Q

What route should be used when a patient is expected to be tube fed for less than 4 weeks?

A

Nasogastric or nasointestinal route

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13
Q

What route should be used when a patient is expected to be tube fed for more than 4 weeks or if the nasointestinal route is inaccessible?

A

Direct route to stomach or intestine may be created by passing a tube through an enterostomy

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14
Q

What is a gastrostomy?

A

Opening in abdominal wall that leads to stomach

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15
Q

What is a jejunostomy?

A

Opening in abdominal wall that leads to jejunum

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16
Q

____ feedings are preferred whenever possible

A

Gastric (nasogastric and gastrostomy)

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17
Q

When are gastric feedings avoided?

A

Patients at high risk of aspiration

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18
Q

What is aspiration?

A

Fluid entering the lungs either from backflow of stomach contents or secretions from mouth and pharynx

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19
Q

Which patients are at high risk of aspiration?

A
  • Patients w/ esophageal disorders
  • Neuromuscular diseases
  • Conditions that reduce consciousness or cause dementia
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20
Q

What are advantages and disadvantages to transnasal route?

A
  • Does not require surgery or incisions for placement

- Long-term use may irritate nasal passages, throat, and esophagus

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21
Q

What are advantages and disadvantages to nasogastric route?

A
  • Easiest to insert and confirm placement

- Highest risk of aspiration

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22
Q

What are advantages and disadvantages to nasoduodenal and nasojejunal route?

A
  • Lower risk of aspiration

- More difficult to insert and risk of tube migration to stomach

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23
Q

What are advantages and disadvantages to tube enterostomies?

A
  • Allow lower esophageal sphincter to remain closed, reducing risk of aspiration
  • Tubes must be placed by physician or sugeon
24
Q

What are advantages and disadvantages to a gastrostomy?

A
  • Feedings can be given intermittently and w/o a pump

- Moderate risk of aspiration

25
Q

What are advantages and disadvantages to a jejunostomy?

A
  • Lowest risk of aspiration

- Most difficult insertion process

26
Q

When are standard enteral formulas used?

A

Individuals who can digest and absorb nutrients w/o difficulty

27
Q

What do standard enteral formulas contain?

A
  • Intact proteins extracted from milk or soybeans

- Carbohydrate sources from hydrolyzed corn starch, glucose polymers, and sugars

28
Q

What are other names for elemental formulas?

A
  • Hydrolyzed
  • Chemically defined
  • Monomeric
29
Q

When are elemental enteral formulas used?

A

Patients who have compromised digestive or absorptive functions

30
Q

What do elemental enteral formulas contain?

A

Proteins and carbs that have been partially or fully broken down that require little, if any, digestion

31
Q

When are specialized enteral formulas used?

A

Patients w/ particular illnesses w/ specific nutrient needs

32
Q

When are modular enteral formulas used?

A

Patients who require specific nutrient combinations to treat illnesses

33
Q

When are intermittent feedings best tolerated?

A

When delivered into the stomach

34
Q

What is bolus feeding?

A

Rapid delivery of a large volume of formula into the stomach (250-500 mL over 5-15 mins)

35
Q

What are advantages to bolus feeding?

A
  • Convenient for patient and staff

- Allow greater independence of patients

36
Q

What are disadvantages to bolus feeding?

A
  • Can cause abdominal discomfort, nausea, and cramping

- Risk of aspiration is higher

37
Q

When is bolus feeding used?

A

For patients who are not critically ill

38
Q

What are continuous feedings?

A

Delivered slowly and at a constant rate over 8-24 hours

39
Q

When are continuous feedings used?

A

Critically ill patients b/c slower delivery is easier to tolerate

40
Q

What are disadvantages to continuous feedings?

A
  • Limit patient’s freedom of movement

- More costly

41
Q

What are contraindications to parenteral nutrition?

A
  • GI tract is functioning and accessible
  • Short-term treatment anticipated (less than 7 days)
  • Risks outweigh benefits
  • Palliative care
  • Patient not stable
  • Inability to obtain venous access
42
Q

Who is parenteral nutrition used for?

A

Patients who are unable to digest or absorb nutrients and who are either malnourished or likely to be

43
Q

What is peripheral parenteral nutrition?

A
  • Nutrients delivered using only peripheral veins
  • Used short term (7-14 days)
  • Solutions must be less concentrated to prevent damage to peripheral veins, so higher volumes are needed
44
Q

What is central peripheral nutrition?

A
  • Aka total parenteral nutrition
  • Nutrients are delivered using the central veins located near the heart
  • Used longer term
  • Solutions can be more concentrated, so volume is lower
45
Q

What is 2-in-1 parenteral solution?

A

Contains dextrose and amino acids; lipid emulsion is administered separately

46
Q

What is 3-in-1 parenteral solution?

A

Contains dextrose, amino acids, and lipids

47
Q

How can parenteral nutrition be administered?

A
  • Continuously (24-hour period)

- Cyclic (8-16 hour period)

48
Q

When can refeeding syndrome occur?

A

When feedings are overly aggressive for severely malnourished individuals

49
Q

What are symptoms of refeeding syndrome?

A
  • Fluid and electrolyte imbalance

- Hyperglycemia

50
Q

What is dysphagia?

A

Difficulty swallowing

51
Q

What are symptoms of dysphagia?

A
  • Drooling
  • Choking or coughing during or after meals
  • Pocketing food
  • Absent gag reflex
  • Inability to suck on straw
  • Chronic upper respiratory infections
52
Q

What does oropharyngeal dysphagia inhibit?

A

Transfer of food from mouth and pharynx to esophagus

53
Q

What does esophageal dysphagia inhibit?

A

Passage of materials through esophageal lumen and into stomach

54
Q

What usually causes esophageal dysphagia?

A

Obstruction in esophagus or motility disorder

55
Q

What are some complications w/ dysphagia?

A
  • Aspiration
  • Dehydration
  • Loss of enjoyment for eating
  • Weight loss
56
Q

What is the difference between a soft diet and soft/minced diet?

A
  • Both are a standard diet modified w/ soft to chew foods

- Soft/minced includes some plain minced meats when soft textured meat is not suitable

57
Q

Is nectar or honey thicker?

A

Honey