CC II Exam 3: Acute Nutritional Support & Inflammation with complete solutions
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Course
CC II E: Acute Nutritional Support & Inflamma
Institution
CC II E: Acute Nutritional Support & Inflamma
ENTERAL NUTRITION correct answers- Tube feedings
- Nutritionally balanced and liquefied food; may also be formula consistency
- Administered thru the stomach, jejunum or duodenum
Example: NG tubes, PEG tubes
Enteral feedings are instituted when a client is unable to take adequate nutrition ...
CC II Exam 3: Acute Nutritional Support
& Inflammation
ENTERAL NUTRITION correct answers- Tube feedings
- Nutritionally balanced and liquefied food; may also be formula consistency
- Administered thru the stomach, jejunum or duodenum
Example: NG tubes, PEG tubes
Enteral feedings are instituted when a client is unable to take adequate nutrition orally.
- need a partially functioning GI tract.
- For extra Nutrition or patients who can not swallow well. correct answersINDICATIONS/POTENTIAL
DIAGNOSES:
- Inability to eat due to a medical condition (comatose, Intubated)
- Pathologies that cause difficulty swallowing or increase risk of aspiration (stroke, advanced Parkinson's
disease, multiple sclerosis)
- Inability to maintain adequate oral nutritional intake & need for supplementation due to increased
metabolic demands (cancer therapy, burns, sepsis)
- Anorexia
- Oral/facial fractures
- Nutritional deficiencies
Nursing interventions:
,- Confirm placement with CXR
- MUST be done before using the tube
- Aspirate and check pH before feedings
During feeding:
- Elevate HOB to 30-45 degrees And for 45-60 min after
- Pause the feeding if pt needs to lay supine & Raise the HOB once feeds resume.
Assess patency:
- Q 4 hours and before/after using tube
- Flush with water before/after feeds to loosen excess that may clog tube. correct answersCheck
placement at least Q shift:
- Aspirate and test pH of stomach contents
- pH < 4 = in stomach; gastrotomy tube
- pH > 6 = jejunum; jejunostomy tube
Checking for residual per protocol:
- Stop feeding if continuous feeding
- Aspirate until you get stomach contents (not the feeding)
- Measure amount
If > 200 mLs, slow it down per protocol and call provider
- Return residual
Assessment (Q 4 hours) correct answersShape and feel of the abdomen
------Overfeeding = distention and firmness
Bowel sounds in all quadrants
, Tenderness with palpation
Stability of tube
- See marker on outside of tube
- Flush with water before & after feeding if not on continuous
- Flush Q 4 hours if on continuous
Daily weight and I&O
Glucose checks for first 24 hours
Complications/ Interventions of enteral feedings:
Disequilibrium syndrome- N/V & headache
Overfeeding
- Overfeeding results from infusion of a greater quantity of feeding than can be readily digested,
resulting in abdominal distention, nausea/vomiting.
NURSING ACTIONS:
- Check residual every 4 to 6 hr.
- Follow protocol for slowing or withholding feedings for excess residual volumes.
- Many facilities hold for residual volumes of 100 to 200 mL and then restart at a lower rate after a
period of rest.
- Check the pump for proper operation and ensure feeding infused at correct rate. correct
answersDiarrhea- due to concentration of feeding.
NURSING ACTIONS
- Slow the rate of feeding & notify the provider.
- Confer with a dietitian.
- Provide skin care and protection.
- Evaluate for Clostridium difficile if diarrhea continues, especially if it has a very foul odor.
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