Podcast
Questions and Answers
Which type of medications may be beneficial in reducing or eliminating diarrhea in patients receiving enteral nutrition?
Which type of medications may be beneficial in reducing or eliminating diarrhea in patients receiving enteral nutrition?
- Antidiarrheal medications (correct)
- Antacids
- Vitamins
- Antibiotics
What should be avoided to prevent clogging the feeding tube when using bulking agents or pectin?
What should be avoided to prevent clogging the feeding tube when using bulking agents or pectin?
- Thickening the formula (correct)
- Mixing with acidic beverages
- Increasing fluid intake
- Using smaller feeding tubes
Why might a predigested formula not be the best 'first line' option for managing diarrhea in patients?
Why might a predigested formula not be the best 'first line' option for managing diarrhea in patients?
- It often causes constipation
- It lacks essential nutrients
- It is too expensive
- It is rarely the cause of the diarrhea (correct)
What is a potential concern related to constipation in bedbound patients receiving long-term enteral feedings?
What is a potential concern related to constipation in bedbound patients receiving long-term enteral feedings?
Which type of medications can cause constipation in patients receiving enteral nutrition?
Which type of medications can cause constipation in patients receiving enteral nutrition?
Under what conditions may diarrhea coexist with constipation in patients on enteral nutrition?
Under what conditions may diarrhea coexist with constipation in patients on enteral nutrition?
What is the typical daily feeding schedule for formula administration?
What is the typical daily feeding schedule for formula administration?
What type of patients are most often successful with the formula administration regimen described?
What type of patients are most often successful with the formula administration regimen described?
When is cyclic feeding commonly used?
When is cyclic feeding commonly used?
Which patients are candidates for continuous feedings according to the text?
Which patients are candidates for continuous feedings according to the text?
How should the feeding rate goal be determined for formula administration?
How should the feeding rate goal be determined for formula administration?
Why is dilution of formulas not recommended according to the text?
Why is dilution of formulas not recommended according to the text?
What should patients receiving parenteral nutrition as their sole source of nutrition receive daily?
What should patients receiving parenteral nutrition as their sole source of nutrition receive daily?
Why is iron not normally part of parenteral infusions?
Why is iron not normally part of parenteral infusions?
How should the first dose of iron be administered to patients on an outpatient basis?
How should the first dose of iron be administered to patients on an outpatient basis?
Which patients are especially sensitive to fluid administration?
Which patients are especially sensitive to fluid administration?
What is the maximum volume of central parenteral nutrition that is generally prescribed daily?
What is the maximum volume of central parenteral nutrition that is generally prescribed daily?
For patients on home parenteral nutrition, how should higher volumes of fluids be administered?
For patients on home parenteral nutrition, how should higher volumes of fluids be administered?
What is the primary complication associated with Parenteral Nutrition (PN)?
What is the primary complication associated with Parenteral Nutrition (PN)?
How often is initial monitoring recommended for patients receiving Home Parenteral Nutrition (HPN)?
How often is initial monitoring recommended for patients receiving Home Parenteral Nutrition (HPN)?
What signs of infection should be monitored for in patients receiving PN?
What signs of infection should be monitored for in patients receiving PN?
Why is monitoring metabolic tolerance critical in patients on Parenteral Nutrition (PN)?
Why is monitoring metabolic tolerance critical in patients on Parenteral Nutrition (PN)?
Which of the following is a potential source for introducing microorganisms into a major vein during PN administration?
Which of the following is a potential source for introducing microorganisms into a major vein during PN administration?
What is of utmost importance in preventing catheter-related bloodstream infections in patients receiving PN?
What is of utmost importance in preventing catheter-related bloodstream infections in patients receiving PN?
What is recommended before discontinuing Parenteral Nutrition (PN)?
What is recommended before discontinuing Parenteral Nutrition (PN)?
How can hunger and satiety cues be reestablished for oral intake during the daytime?
How can hunger and satiety cues be reestablished for oral intake during the daytime?
When are oral diets often attempted in practice after enteral feeding?
When are oral diets often attempted in practice after enteral feeding?
What is the primary purpose of commercial formulas for oral supplementation?
What is the primary purpose of commercial formulas for oral supplementation?
How many grams of intact protein do most commercial oral supplements provide approximately in an 8 oz portion?
How many grams of intact protein do most commercial oral supplements provide approximately in an 8 oz portion?
What is an important consideration when transitioning from Enteral Feeding to Oral Feeding?
What is an important consideration when transitioning from Enteral Feeding to Oral Feeding?
Study Notes
Diarrhea and Constipation Management
- Adjusting medications or administration methods can reduce or eliminate diarrhea.
- FOS, pectin, guar gum, bulking agents, and antidiarrheal medications can be beneficial in managing diarrhea.
- Constipation is a concern, especially among bedbound patients, and fiber-containing formulas or stool-bulking medications may be helpful.
- Narcotic pain relievers and iron supplements can cause constipation.
Monitoring Tolerance and Nutrient Intake
- Monitoring a patient's actual intake and tolerance is crucial to ensure nutrition goals are achieved.
- Monitoring metabolic and gastrointestinal tolerance, hydration status, weight, and lean body mass is essential.
- Patients receiving PN require added multivitamins and trace elements daily and close monitoring.
Fluid and Electrolyte Balance
- Fluid needs for PN or EN are calculated similarly, with maximum volumes rarely exceeding 3 L.
- Volumes of prescribed CPN should be coordinated with the overall care plan, especially for patients with cardiopulmonary, renal, and hepatic failure.
Monitoring and Evaluation
- Routine monitoring of PN is necessary, especially for hospital patients.
- Monitoring is done to evaluate response to therapy and ensure compliance with the treatment plan.
Complications
- Infection is the primary complication associated with PN, and strict adherence to protocols is necessary.
- Monitoring for signs of infection, such as chills, fever, tachycardia, sudden hyperglycemia, or elevated white blood cell count, is crucial.
Transitioning to Oral Feeding
- A stepwise decrease in EN is used to transition to oral feeding.
- Oral supplements can be used to augment solid foods, providing approximately 250 kcal/8 oz or 240-ml portion and approximately 8 to 14 g of intact protein.
Formula Administration
- Formula administration is initiated at 100 to 150 ml per feeding and increased incrementally as tolerated.
- Cyclic feeding allows for a period of time away from the tube feeding.
Continuous Feeding
- Continuous infusion of EN requires a pump and is appropriate for patients who do not tolerate volume infusion used with bolus, cyclical, or intermittent methods.
- Patients with compromised gastrointestinal function are candidates for continuous feedings.
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Description
Test your knowledge on the administration of enteral feeding. Learn about the recommended initial feeding amounts, strategies for increasing feeds, and the benefits of cyclic feeding. Explore typical daily feeding schedules and the use of enteral feeding as a transition to oral feedings.
