ENTERAL AND PARENTERAL NUTRITION

Question 1

through the gastrointestinal system

Answer 1

enteral

Question 2

through intravenous methods

Answer 2

parenteral

Question 3

also known as tube feeding, is a
way of delivering nutrition
directly to your gastrointestinal
(GI) tract or small intestine
usually from a tube, catheter,
or stoma

Answer 3

enteral nutrition (EN)

Question 4

uses of a feeding tube

Answer 4

• provide nutrition
• provide fluids
• provide medication
• decompressing the stomach
• removing stomach contents

Question 5

types of tubes for enteral feeding

Answer 5

• nasogastric tube
• nasoenteric tube
• gastrostomy tube
• jejunostomy tube

Question 6

• starts in the nose and ends in the stomach
• used for feeding clients who have adequate gastric emptying, and who require shorter-term feedings

Answer 6

nasogastric

Question 7

• starts in the nose and ends in the intestines
• indicated for use in enteral nutrition in both gastric and small
  intestine regions, such as the duodenum and jejunum. They
  are ideal for short‐term feeding, especially patients at risk for
  aspiration, reflux, and gastric emptying delay

Answer 7

nasoenteric

Question 8

2 sub types of nasoenteric

Answer 8

nasoduodenal
nasojejunal

Question 9

starts in the mouth and ends in the stomach

Answer 9

orogastric

Question 10

starts in the mouth and ends in the intestines

Answer 10

oroenteric

Question 11

• feeding tube inserted through a surgical opening in the neck and passed through the esophagus, with the tip resting in the stomach
• used for patients with head and neck cancer

Answer 11

esophagostomy

Question 12

• placed through the skin of the abdomen straight to the stomach
• used when a patient cannot
  or will not eat for longer than
  four weeks and has a
  functional gut

Answer 12

gastrostomy tube

Question 13

subtypes of gastrostomy tube

Answer 13

PEG, button tubes

Question 14

• placed through the skin of the abdomen straight into the jejunum intestines
• are useful for patients with contraindications to gastrostomy

Answer 14

jejunostomy tube

Question 15

subtypes of jejunostomy tube

Answer 15

PEJ, PRJ tubes

Question 16

is the most common complication of tube feeding usually caused by protein-energy malnutrition, medications, motility, infection, impaction, infusion rate, osmolality and bacterial contamination of formula

Answer 16

diarrhea

Question 17

the most dangerous complication of enteral feeding and is among the leading causes of death in tube-fed patients

Answer 17

aspiration of formula

Question 18

common metabolic complications

Answer 18

electrolyte imbalance, hyperglycemia, refeeding syndrome

Question 19

also called “standard” or “polymeric” formulas and contains
unaltered molecules of protein, carbohydrates and fat.

Answer 19

intact formulas

Question 20

are predigested micronutrients. They are either elemental
or semi-elemental formulas

Answer 20

hydrolyzed formulas

Question 21

are individually packaged components that may be
combined to meet the nutritional
requirement of the patients

Answer 21

modular formulas

Question 22

are formulas that have been
altered in one or more nutrients in order to optimize nutrition support without exacerbating the metabolic disturbances associated with various diseases

Answer 22

nutrient modified and disease specific formulas

Question 23

• the most commonly used method of enteral feeding; often referred to
  as a “kangaroo pump”
• indicated for patients who
  are unable to tolerate high volume feedings

Answer 23

continuous method

Question 24

• solution is infused at a constant
  rate controlled by a pump
• administered over at least 30 min.;
  continuous rate over a 16 to 24-
  hour pd

Answer 24

continuous method

Question 25

- continuous drip method over a period of 8-20 hours per day using a pump to control delivery - usually given at night; allowing independence from feeding equipment during the day - may be used when feeding into the stomach or small intestine

Answer 25

cyclic feeding

Question 26

- usually requires a higher infusion rate which requires closer monitoring for formula and delivery tolerance - usually well-tolerated and effective for malnourished patients especially for the ambulatory elderly population

Answer 26

cyclic feeding

Question 27

allow for more mobility than continuous drip feedings because there are breaks in the feedings, allowing the patient to be free from the tube feeding apparatus or activities such as physical therapy

Answer 27

bolus feeding

Question 28

closely mimics usual eating pattern and involves shorter period of infusion at specified intervals – usually four to six times a day.

Answer 28

bolus feeding

Question 29

characterized by rapid administration of the formula usually less than 15 minutes into the GI tract by syringe or feeding bag

Answer 29

bolus feeding

Question 30

uses a similar technique to that of bolus feeding, but it is used over a longer duration, which may help improve tolerance

Answer 30

intermittent delivery

Question 31

- use an open-top container or syringe - provided in flip-top cans powdered formula or blenderized formula

Answer 31

open system

Question 32

formula left over from open system delivery should be discarded after?

Answer 32

8-12 hours OR 24 hours

Question 33

consists of pre-filled container that is spiked with enteral tubing & attached to enteral access device

Answer 33

closed system

Question 34

viability of closed system feeding formulas

Answer 34

48 hours

Question 35

what do you do to prevent clogging of tube?

Answer 35

flush tube with 5-10 cc of water before and after administration

Question 36

provided when the gastrointestinal tract is nonfunctional because of an interruption in its continuity or because its absorptive capacities is impaired

Answer 36

parenteral nutrition

Question 37

TPN CVN IVH

Answer 37

total parenteral nutrition central venous nutrition intravenous hyperalimentation

Question 38

TPN solutions are ___, they are injected only into high-flow central veins, where they are diluted by the client’s blood

Answer 38

hypertonic

Question 39

When TPN therapy is to be discontinued, the TPN infusion rates are decreased slowly to prevent ___

Answer 39

hyperinsulinemia hypoglycemia

Question 40

weaning of TPN may take up to ___ hours

Answer 40

48