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NBCD > Chapter 16: Nutrition Support > Flashcards

Chapter 16: Nutrition Support Flashcards

(73 cards)

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1
Q

the delivery of formulated enteral or parenteral nutrients to appropriate patients for the purpose of maintaining or restoring nutritional status

A

nutrition support

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2
Q

2 modes of nutrition support employed by practitioners for the nutritional care of a patient

A

enteral nutrition; parenteral nutrition

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3
Q

refers to the provision of nutrients both orally and via tube directly into the git

A

enteral nutrition

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4
Q

administer if preferred mode is:
-oral feeding, normal route og ingesting nutrients
-individual is not able to eat the adequate amounts required by the body either due to oral and swallowing problems, or a very high nutritional requirements

A

administering enteral feeding

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5
Q

in administering tube feeding (enteral nutrition), these are important consideration (3)

A

-functioning git
-length of feeding
-presence or risk of aspiration

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6
Q

patients with functional git but unable to orally ingest adequate nutrients to meet nutritional requirements can benefit from tube feeding

A

enteral feeing/tube feeding

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7
Q

indications for enteral feeding

_____ with inadequate oral intake of nutrients for the previous 5 days or normal nutritional status but with inadequate oral intake for the previous 7-10 days

A

protein-calorie-malnutrition

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8
Q

indications for enteral feeding

_____, such as comatose state, CVA, and parkinson’s disease

A

central nervous system disorders

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9
Q

indications for enteral feeding

_____, such as crohn’s disease, gastroparesis, short bowel syndrome, and chronic pancreatitis

A

git diseases

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10
Q

indications for enteral feeding

_____, such as severe depression and anorexia nervosa

A

psychiatric disorders

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11
Q

indication when nutritional requirements are still not met through oral nutrition supplements or tube feeding

A

parenteral nutrition

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12
Q

enteral nutrition preferred over parenteral nutrition because it is _____ (3)

A

safer, economical, and maintains gut structure and integrity

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13
Q

tube feeding routes of access depends on consideration upon assessment

nasogastric/nasoduodenal/nasojejunal, jejunostomy or percutaneous endoscopic gastronomy, or multiple lumen tubes

A

-

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14
Q

contraindications to enteral feeding

A

-complete intestinal or colonic obstruction
-intractable vomiting
-active git bleeding and shock

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15
Q

enteral nutrition formulas

are often classified to their (2)

A

protein content
overall macronutrient content

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16
Q

enteral nutrition formulas

composed of chon, cho, and fat in high molecular weight form and therefore have lower osmolality

formula require normal digestive and lipolytic activity

A

polymeric formula (nutritionally complete)

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17
Q

enteral nutrition formulas

have a low residue and use free amino acids or peptides as a protein source

oligosaccharides or monosaccharides provide the cho source and most contain medium as well as long chain triglycerides

A

elemental formula (chemically defined)

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18
Q

enteral nutrition formulas

not nutritionally complete because they contain single nutrients, such as cho, fat, or chon

can be added to standard enteral products

A

modular formula

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19
Q

enteral nutrition formulas

available for use in patients with a variety of clinical conditions including renal, respiratory, hepatic insufficiency, diabetes, immunocompromised states, and fat or cho malabsorption

A

specialty/disease-specific formula

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20
Q

tube feedings could also be prepared by liquefying regular foods that are selected from the soft diet using a blender

A

blenderized tube feeding

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21
Q

advantages of this type of feeding:
-cost effectiveness
-health benefits from using whole foods
-ability to tailor the formula exactly to patient needs

A

blenderized tube feeding

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22
Q

btf are contraindicated for patients who are immunocompromised, for infusion tubes smaller than _____, for continuous feeding (unless formula hangs for less than 2 hrs)

A

10 french

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23
Q

btf

if fluid restriction of less than _____ is requires, in cases of multiple food allergies, and if a jejunostomy tube (jt) is used

A

900 ml/day

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24
Q

enteral feeding for acute pancreatitis requires

A

very low fat-containing formula

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25
btf considerations may have a direct effect on git side effects and therapy tolerance to enteral therapy
formula osmolality
26
btf considerations mineral contents of the formula (4)
Mg, Na, P, K
27
fluid requirements recommended daily water requirement in the absence of hepatic, renal, or cardiac disease is _____
1ml/kcal
28
most 1 ml/kcal formulas contain approx. _____ of water patients w/o fluid restriction should receive additional free water to at least 25% of the total formula volume which can be a
75%
29
most 1 ml/kcal formulas contain approx. 75% of water patients w/o fluid restriction should receive additional free water to at least 25% of the total formula volume which can be administered into _____ or _____ separate doses
2-3
30
an ideal formula is
isotonic
31
isotonic: ideal formula (ideal nutrient density) for adults
1 kcal per 1 ml
32
isotonic: ideal formula (ideal nutrient density) for infants
2/3 kcal per 1 ml
33
fluid requirements the more _____ the formula, the higher the osmolality
concentrated
34
fluid requirements is the size and number of the nutrient particles in a solution
osmolality
35
fluid requirements ideal enteral formula should be characterized by their (2)
bacteriological safety; ease of administration
36
necessary to detect and prevent complications
monitoring
37
monitoring make sure that the patients head and neck are elevated at _____ degrees always and for 1 hour after feeding to prevent aspiration
30-45
38
enteral feeding - complications when there is obstruction of tube lumen or tube displacement
mechanical
39
enteral feeding - complications when there is esophagitis or ulceration
esophageal complications
40
enteral feeding - complications caused by nasal erosions and sloughing of nasal cartilage due to excessive pressure on the nasal cartilage
nasopharyngeal complications
41
enteral feeding - complications sudden nausea, vomiting, or diarrhea which may be due to improper formula temperature, irregular or too rapid administration of formula, or bacterial contamination
gastrointestinal complications
42
enteral feeding - complications in cases of hypernatremia, hyponatermia, hypercalcemia, and azotemia, which may be prevented by proper monitoring and fluid intake
metabolic complications
43
modes and rates of feeding the rapid delivery by syringe of 240-400 ml of formula every 4-6 hrs simulates normal food intake in terms of gallbladder motility
bolus feeding
44
modes and rates of feeding involves provision of 100-400 ml of enteral formula with an interval of 2-4 hrs can be sued if there has been no history of malabsorption
timed intermittent
45
modes and rates of feeding requires infusion of the formula using a pump or gravity drip over a period of 16-24 hrs
continuous drip
46
modes and rates of feeding infuses the formula for 8-16 hrs, usually overnight, using an infusion pump
cyclic administration
47
the delivery of nutrients directly into the blood stream
parenteral nutrition
48
it is also called intravenous (IV) nutrition, or total parenteral nutrition (TPN), given to patients w/o a functional GIT given when the condition is expected to continue on a minimum of 7 days
parenteral nutrition
49
TPN meaning
total parenteral nutrition
50
TPN - indications -intractable vomiting (acute pancreatitis) -severe diarrhea of >_____ ml/day stool, or malabsorption such as in the case of severe acute flare of the inflammatory bowel disease, radiation enteritis with weight loss -severe trauma or major abdominal surgery -small bowel or colon obstruction
500 ml/day
51
TPN - contraindications _____ unstable patients including those with hypovolemia, cardiogenic, or septic shock
hemodynamically
52
TPN - contraindications patients with severe _____ or fluid overload
pulmonary edema
53
TPN - contraindications patients with _____ w/o dialysis
anuria
54
TPN solution - components fluid volume: fluid intake about about _____ liters per day and should not exceed 4 liters
2-3 liters
55
TPN solution - components cho: are given as dextrose or _____
glucose monohydrate
56
TPN solution - components cho: are given as dextrose or glucose monohydrate which yields _____ kcal/g
3.4 kcal
57
TPN solution - components chon: comes in the form of _____ amino acids available in concentrations of 8.5-15%, although other concentrations can be provided as indicated the amino acids is diluted with the appropriate amount of dextrose to achieve a desired concentration
crystalline amino acids
58
TPN solution - components lipid emulsions: are _____ and are a valuable caloric source if peripheral parenteral nutrition is used come in 10% and 20% emulsions of soybeans or safflower oil, may be available in 100, 200, 250, and 500 ml bottles
isotonic
59
TPN solution - components electrolytes: _____ content must be adjusted according to serum electrolyte concentration if possible, electrolyte imbalances should be corrected before initiating parenteral nutrition
parenteral electrolyte
60
TPN solution - components vitamins and minerals: multivitamins, except vitamin _____, are provided in concentrated formulations based on standard recommendations some minerals may be supplied using proper dose calculations
vitamin k
61
TPN solution - components additives: such as _____ and _____ are used only when necessary
insulin and heparin
62
TPN nutrition - administration the site of parenteral infusion of nutrients depends on the (3)
caloric level and source, fluid tolerance, and vascular access
63
TPN nutrition - administration are delivered thru a peripheral IV catheter inserted into a small diameter peripheral vein
simple iv infusions
64
TPN nutrition - administration is used for patients with mild nutritional deficiencies; uses the small diameter veins that carry blood from the arms and legs
peripheral parenteral nutrition
65
TPN nutrition - administration peripheral parenteral nutrition: _____ are commonly used to provide short-term nutrition, usually 1-2 weeks
lipid emulsions
66
TPN nutrition - administration refers to the infusion of concentrated solutions delivered thru the central veins for a longer period
central parenteral nutrition
67
TPN nutrition - complications refers to the presence of air in the chest
pneumothorax
68
TPN nutrition - complications is the presence of the disease-causing microorganisms in the blood
sepsis
69
TPN nutrition - complications presence of air in the tube or in the blood vessel that obstructs the parenteral flow
air embolism
70
TPN nutrition - complications pertains to the presence of blood in the chest
hemothorax
71
TPN nutrition - complications _____ deficiency's symptoms include: failure to grow, dermal problems, and poor immune system
essential fatty acids
72
TPN nutrition - complications characterized by an increase or a decrease of nutrients in the blood
metabolic imbalance
73
aggressive administration of nutrition, particularly via the intravenous route, can precipitate _____ with severe, potentially lethal electrolyte fluctuations involving metabolic, hemodynamic, and neuromuscular problems
refeeding syndrome

NBCD (89 decks)

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