PN TPN

Question 1

Enteral access depends on

Answer 1

Length of time
Degree of aspiration risk 
Clinical status 
Digestion and absorption 
=======
!!!!!!!!!!!!!!!
PATIENT’s ANATOMY  if they are very obese they can’t place PEG tube, doctor won’t be able to visualize it

Question 2

Short term feeding

Answer 2

Nasal feeding
NGT
NJT
NDT

Question 3

***NGT also used for

Answer 3

Surgery to belly

Used for gastric decompression - gets things out of belly

Question 4

Long term enteral nutrition. More than 3-4 weeks feeding needed

Answer 4

PEG OR PEJ

Meds feed into small bowel

Question 5

Small tube size

Answer 5

5-12 French units
Small bore
NG

Question 6

Large bites feeding

Answer 6

Maior que 14 F
BIGGER TUBE LESS CLOGGING
2 kcal formulas or fiber formulas don’t flow as easily in small ones

Question 7

Defined formula

Answer 7

Elemental, semi elemental

Question 8

Disease specific formula

Question 9

Modular formula

Answer 9

Pro fat CHO fiber as single nutrient

Promod e Juven

Question 10

Blenderized

Answer 10

Homemade

Question 11

*** standard POLYMERIC FORMULA

Answer 11

All macros are together, not broken down
Protein intact
Macros intact
Requires normal digestion and absorption

Question 12

*** Large bores feeding benefit

Answer 12

Reduce clogging

Question 13

The more concentrated a formula

Answer 13

The more hydration needed

Question 14

**Administration enteral gastric feeding start

Answer 14

At lower rate
Increase 8-12 hours to goal
Initiate at 25-50 ml/hr
Advance by 25 ml/hr every 8-12 hours to final volume

Question 15

****ASPIRATION PNEUMONIA

Prevention

Answer 15

Results from gastric formula or throat and saliva contents breathed into lungs

ELEVATED HEAD OUT OF BED DURING AND AFTER FEED
DONT WANT THEM LIE ON THEIR BACK TUBE FEEDING CAN COME UP AND ASPIRATE INTO LUNG

Question 16

*****most common complications enteral feeding

Answer 16

Diarrhea

Question 17

*****You can’t residual volume

Type of feeding

Answer 17

JT - no reservoir there to hold anything

Question 18

PARENTERAL NUTRITION 2 ways

Answer 18

PPN AND CNP/TPN

PPN - Peripheral parenteral nutrition
Short time, limited amount, need a lot of volume, so someone with fluid restrictions you can’t do this

CNP TPN
50% dextrose
Higher caloric
Can do more volume ok for volume sensitive

Question 19

**** cut off osmolarity for PPN

Answer 19

900 mOsm

Question 20

feeding you can give limited amount of nutrition

Answer 20

PPN

Question 21

**Minimal rate of CHO administration

Answer 21

5-6 mg/kg/min in critically ill patients

Question 22

osmolarity formula

Answer 22

5 x dextrose + 10 x protein + 150 de elerolytes

Question 23

percetage of fat that will meet EFA needs

Answer 23

10 %

Question 24

This type TF may contribute to the development of diarrhea

Answer 24

HYPERTONIC

Question 25

TF can be initiated at full strength

Answer 25

TRU

Question 26

What's the amount of free water in a 1 L bottle of TF that is 81 % free water?

Answer 26

810 mL

Question 27

A standard 1.2 kcal/ml formula is infused at 45 ml/hr. How many cals does this give in 24 hours ?

Question 28

Jevity 1.5 @ 50/hr x 20 hrs provides how many kcals?

Question 29

fat emulsion in PN should not be higher than 50 % of kcal

Answer 29

false

Question 30

5 mg/kg/min is the maximum rate of infusion used for

Question 31

1 L of AAA7 D20 with 250 ml of 20 % lipids provides | g pro g CHO

Question 31

1 L of AAA7 D20 with 250 ml of 20 % lipids provides | g fat kcal

Question 32

1 L of AAA7 D20 with 250 ml of 20 % lipids WOULD be provided via

Question 33

transitional parenteral to enteral

Answer 33

when pt meets 60 % of nutrient needs

Question 34

transitional feeding enteral to oral

Answer 34

when 60 % of nutrient needs consistently met by oral intake decrease PN

Question 35

refeeding syndrome

Answer 35

he potentially fatal shifts in fluids and electrolytes that may occur in malnourished patients receiving artificial refeeding GLUCOSE K P MG