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GI Exam 1 > Adult Enteral Nutrition > Flashcards

Flashcards in Adult Enteral Nutrition Deck (24):
1

First rule to enteral nutrition=

If the gut works, USE IT!

2

Enteral nutrition benefits

- Decrease in infectious complication and improved outcomes
- Plays a role in maintaining gut mucosal growth and development to preserve gut function
- Prevent stress related damage/ulcers
- Fewer metabolic complications
- reduced risk of developing cholestasis, gallbladder sludge and gallstones
- Avoids complications with placement
- Less costly

3

***Contraindication for Enteral nutrition

Mechanical obstruction
Diffuse peritonitis
Severe diarrhea
Severe GI hemorrhage
Intractable vomiting
Chronic intestinal pseudo-obstruction
Severe malabsorption

4

Functionality of the GI Tract

Got to have enough jejunum and ileum to absorb food
Decreased transit time due to removal of a valve
Reduced gastric emptying (risk of N/V and pulmonary aspiration)

5

Most common carbohydrate source is

corn syrup

6

Most common fat source is

Corn oil or palm kernel oil

7

Most common protein source is

Milk protein

8

Elemental is only used in those that:

have poor absorption

9

Partially hydrolyzed =

Rarely every used

10

Amino Acids that are not normally essential but in disease states they are:

Glutamine and arginine due to in high physiologic stress they become deficient

11

Glutamine function

Fuel for enterocyte
Helps maintain integrity of gut mucosa

12

Supplemental arginine does what:

Decrease protein catabolims
Enhance
nitrogen retention
Accelerate wound healing

13

Sufficient linoleic acid is required to

prevent essential fatty acid deficiency and should be 1-3% of daily total calories

14

Fiber functions

Decrease bacteria
Reduce incidence of diarrhea and helps keep the colon clean

15

Standard Polymeric:

Used 90% of the time
Jevity is most common
1-1.2 kcal/mL
Typically have to add water

16

High protein use

>1.5 g/kg/day requirement
Trauma pts with burns, pressure sores, or wounds

17

High caloric density use

Typically in fluid restricted pts

18

Elemental and peptide based use

Pts who have absorption problems: short bowel, colon removed

19

Pulmonary and diabetic use

Low carbs

20

EN Regimen Considerations

- Evaluate risk of aspiration
- Flush feeding tube with at least 30 mL of sterile water every 4 hours during continuous feeding
- Schedules of progression and advancement should be individualized
- Do not dilute formulas bit add free water as boluses intermittently
- If GRV is >250 mL after second residual check, add a promotility agent
- GRV > 500 mLshould result in holding EN and evaluate tolerance

21

Electrolytes, BUN/SCr, glucose monitoring

Daily during initiation
Every 1-3 months during stable

22

Ca, Mg, P monitoring

3-7 per week during initiation
Every 1-3 months during stable

23

Liver function test monitoring

Weekly during initiation
Every 1-3 months during stable

24

Trace elements and vitamins monitoring

If deficiency or toxicity is suspected