Exam (elaborations)
Enteral and Parenteral Nutrition
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Enteral and Parenteral Nutrition Enteral and Parenteral Nutrition Enteral and Parenteral Nutrition
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Enteral and Parenteral NutritionWhat are the 5 main indications for enteral nutrition? - ANS 1. Protein-energy malnutrition and
inadequate oral intake for >/= 5 days
2. Meeting < 50% of nutrient needs for 5-7 days
3. Severe dysphagia
4. Coma
5. Low output enterocutaneous fistula
Who should NOT get enteral nutrition, what are some of the contraindications? - ANS 1. Intestinal
obstruction, ileus, or hypomotility
2. Severe diarrhea or vomiting
3. Severe hemodynamic instability
4. Major upper GI bleeding
5. Prognosis doesn't warrant aggressive nutrition support
6. High output enterocutaneous fistula
What feeding access is used for short term enteral nutrition? - ANS nasal and oral tube feeding
What feeding access is used for long term enteral nutrition? - ANS G-tube, J-tube, PEG, PEG-J, or PEJ
tube
What is gastroparesis? - ANS Stomach emptying is delayed so there is an increased risk for aspiration
-when the stomach isn't moving food through the stomach and into the duodenum
What is dumping syndrome? - ANS occurs when hypertonic contents enter the small intestine, causing
an influx of fluid into the lumen
, -occurs within 1 hour of eating or EN administration
What are symptoms of dumping syndrome? - ANS epigastric fullness, weakness, dizziness, vertigo,
diaphoresis, tachycardia, and/or abdominal cramping
What steps can you take to prevent dumping syndrome with EN? - ANS tapering up infusion rates, using
continuous instead of bolus feeds, and using isotonic formula
What steps can you take to prevent dumping syndrome with oral intake? - ANS avoiding fluids with
meals, avoiding fatty foods, and avoiding high sugar foods
When should you initiate PN: Well-nourished stable patients who is unable to meet at least 50% of
nutritional needs PO or via enteral nutrition - ANS initiate PN after 7 days
When should you initiate PN: Nutritionally at-risk patient unlikely to achieve sufficient oral or EN intake -
ANS Initiate PN within 3-5 days
When should you initiate PN: Moderately or severely malnourished patient in which oral intake or EN is
not possible - ANS Initiate PN as soon as possible
When should you initiate PN: Metabolically unstable patient - ANS delay PN until condition is improved
Which of the following types of enteral nutrition is recommended for patients who will need enteral
feeding for more than 4 weeks after undergoing an esophagectomy?
a. Nasogastric
b. Gastrostomy
c. Jejunostomy
d. Nasojejunal - ANS C. jejunostomy
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