Specialized Nutritional Support and Enteral Nutrition
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Specialized Nutritional Support and Enteral Nutrition

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Questions and Answers

What is a crucial aspect to assess when evaluating a patient's capacity for wound healing?

  • Underlying medical conditions affecting circulation (correct)
  • The patient's dietary preferences
  • The stage of recovery from anesthesia
  • Current levels of physical activity

    • Which of the following enteral feeding access routes is appropriate for short-term use?

  • Nasojejunal tube (correct)
  • Gastrostomy tube
  • Total parenteral nutrition
  • PEG feedings

    • What laboratory test is essential in assessing potential electrolyte imbalances in patients?

  • Liver function tests
  • Serum electrolyte tests (correct)
  • Complete blood count
  • Blood glucose levels

    • What factor can contribute to the variability in wound healing times for different patients?

    <p>Presence of underlying conditions like malnutrition</p> Signup and view all the answers

    Which of these factors is NOT directly relevant to assessing a patient's wound healing capability?

    <p>Frequency of medication administration</p> Signup and view all the answers

    Which feeding method is specifically indicated for patients who are not consuming food well during the day?

    <p>Cyclic feeding</p> Signup and view all the answers

    What is the primary advantage of bolus feeding in patients with a gastrostomy?

    <p>It is administered rapidly, requiring only 5-10 minutes.</p> Signup and view all the answers

    Which characteristic defines intermittent feeding?

    <p>It involves administering nutrition with scheduled intervals.</p> Signup and view all the answers

    How often is bolus feeding typically repeated for effective nutrition delivery?

    <p>4-6 times daily</p> Signup and view all the answers

    Which of the following statements about cyclic feeding is false?

    <p>It is not suitable for patients with gastric or small bowel access.</p> Signup and view all the answers

    Which of the following is a potential contraindication for enteral nutrition?

    <p>Ileus</p> Signup and view all the answers

    What condition is characterized by inflammation of the peritoneum?

    <p>Peritonitis</p> Signup and view all the answers

    What is a potential result of severe wasting during exercise?

    <p>Burning of fat first</p> Signup and view all the answers

    Which factor could lead to the need for dose adjustment in medication administration?

    <p>Gastrointestinal function not returning</p> Signup and view all the answers

    What is likely to occur in the presence of bowel ischemia?

    <p>Lack of oxygen to the intestinal area</p> Signup and view all the answers

    What dietary condition could lead to ineffective oral intake?

    <p>Intractable vomiting</p> Signup and view all the answers

    Which condition represents a macronutrient deficiency associated with low protein intake?

    <p>Kwashiorkor</p> Signup and view all the answers

    What can impair digestion and absorption in patients requiring enteral nutrition?

    <p>Severe wasting and depressed growth</p> Signup and view all the answers

    What is a significant advantage of parenteral nutrition compared to enteral nutrition?

    <p>Early calorie intake through the bloodstream</p> Signup and view all the answers

    Which of the following is NOT a disadvantage of parenteral nutrition?

    <p>Reduced bioavailability of nutrients</p> Signup and view all the answers

    What characteristic of parenteral nutrition contributes to its high caloric density?

    <p>Concentrated formulation with less fluid</p> Signup and view all the answers

    In which patient conditions is parenteral nutrition especially utilized?

    <p>Patients with severe gastrointestinal disorders</p> Signup and view all the answers

    How does parenteral nutrition affect the gastrointestinal tract?

    <p>Impairs gut motility due to lack of food intake</p> Signup and view all the answers

    What is the primary delivery method for parenteral nutrition?

    <p>Intravenous administration</p> Signup and view all the answers

    What does the term 'catabolism' refer to in the context of nutrition?

    <p>Breakdown of complex substances</p> Signup and view all the answers

    What disadvantage does parenteral nutrition pose regarding gut health?

    <p>Leads to starving of the gut</p> Signup and view all the answers

    What is the recommended goal volume per feeding for enteral nutrition?

    <p>200-500 mL</p> Signup and view all the answers

    Which complication is directly associated with enteral nutrition?

    <p>Hypernatremia</p> Signup and view all the answers

    What is the range of feeding delivery time for enteral nutrition?

    <p>20-60 minutes</p> Signup and view all the answers

    Which of the following routes of administration is NOT typically used for enteral nutrition?

    <p>Intravenous</p> Signup and view all the answers

    What is a key monitoring parameter during enteral nutrition?

    <p>Blood glucose concentration</p> Signup and view all the answers

    Which ingredient is NOT part of a standard polymeric formula for enteral nutrition?

    <p>Artificial sweeteners</p> Signup and view all the answers

    In what situation would enteral feeding be indicated?

    <p>Neurological or psychiatric conditions preventing oral intake</p> Signup and view all the answers

    Which method of administration allows for the use of gravity in delivering nutrients?

    <p>Gravity-assisted</p> Signup and view all the answers

    What is one of the recommendations for positioning a patient during enteral feeding?

    <p>Elevate the head of the bed</p> Signup and view all the answers

    What concentration of calories per milliliter does a standard polymeric formula typically provide?

    <p>1 to 1.2 kcal/mL</p> Signup and view all the answers

    What is the primary energy contribution of amino acids used in parenteral nutrition?

    <p>4 kcal/g</p> Signup and view all the answers

    For patients receiving ECMO, what is the typical threshold for oxygen saturation to be considered normal?

    <blockquote> <p>95%</p> </blockquote> Signup and view all the answers

    Which component is NOT a characteristic of single macronutrient supplements?

    <p>Mixed with other nutrients</p> Signup and view all the answers

    What is the maximum dosage of glucose for critical illness as noted in parenteral nutrition guidelines?

    <p>4 mcg/kg/min</p> Signup and view all the answers

    Which of the following macronutrients provides the largest percentage of non-protein calories in typical parenteral nutrition?

    <p>Carbohydrates</p> Signup and view all the answers

    Why are powdered protein supplements often used by athletes and bodybuilders?

    <p>They serve as a primary protein source</p> Signup and view all the answers

    What do amino acids primarily provide for the body?

    <p>Nitrogen</p> Signup and view all the answers

    In what condition are single macronutrient supplements likely to be included in a patient's diet?

    <p>Nutritional supplementation for organ failure</p> Signup and view all the answers

    What defines a non-functional gastrointestinal (GI) tract in the context of nutritional needs?

    <p>Inability to process oral intake</p> Signup and view all the answers

    What is the recommended daily caloric intake for stable patients undergoing parenteral nutrition?

    <p>25-30 kcal/kg</p> Signup and view all the answers

    Study Notes

    Specialized Nutritional Support

    • Offered to malnourished or at-risk patients when beneficial to outcomes/quality of life
    • Malnutrition is present when body isn't receiving sufficient nutrients (even if not all are deficient)
    • Nutritional assessment based on patient history and physical data (weight loss, duration, amount; dietary intake before admission; disease severity, comorbidities)
    • Function of gastrointestinal tract assessed (needed for enteral nutrition)
    • Specialized nutrition aims to improve nutritional value of food, personalized for the patient for adequate daily intake

    Enteral Nutrition

    • Provided when gastrointestinal function is impaired
    • Unable to consume nutrition orally, inability to swallow, impaired digestion/absorption/metabolism
    • Severe wasting, depressed growth, malnutrition signs are possible
    • Enteral nutrition keeps food moving via the digestive tract
    • Advantages: promotes gut health, stimulates hormone secretion, reduces risk of infection, short hospital stay
    • Disadvantages: risk of necrotizing enterocolitis, requires careful monitoring, tube-related complications (e.g. curling, rupture)

    Parenteral Nutrition

    • Used if enteral nutrition maximized, gastrointestinal dysfunction, poor tolerance/accessibility
    • Hypermetabolic state
    • Advantages: early calorie intake, prevents catabolism, full bioavailability
    • Disadvantages: risk of starving the gut, growth restriction, infection risk, cost

    Nutritional Assessment Process

    • Assess gastrointestinal function first
    • If functional, enteral nutrition
      • Short-term (nasogastric, nasoduodenal, nasojejunal)
      • Long-term (gastrostomy, jejunostomy)
    • If not functional, parenteral nutrition
      • Short-term: peripheral PN
      • Long-term/fluid restriction: central PN

    Contraindications

    • Intestinal obstruction, Ileus, Inability to tolerate oral intake, Peritonitis, Bowel ischemia, Intractable vomiting/diarrhea

    Enteral Feeding Methods

    • Cyclic: Overnight feeding
    • Bolus: Rapid delivery
    • Intermittent: Delivery with intervals
    • Patients requiring intermittent: those who cannot tolerate bolus feedings,
    • Feedings (20-60 minutes or 5-10 minutes)
    • Examples: syringe (repeated4-6 times/day)

    Nutritional Formulas

    • Standard polymeric: Milk-based, complete; for no diet restrictions
    • Elemental: Hydrolyzed protein/fat; easier on GI tract; no restrictions or no diet limitations
    • High protein: High protein content
    • High caloric density: Concentrated with less fluid/electrolytes; for kidney failure/heart disease;

    Monitoring

    • Frequent assessment of patient tolerance, potential complications, nutritional values in relation to patient's condition.
    • Important for potential complications for tube feeding, like aspiration or tube-site care.
    • Frequent daily weighing
    • Monitor for complications, including bowel issues and other complications.

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    Description

    This quiz focuses on specialized nutritional support and enteral nutrition, which are critical for patients with malnutrition or gastrointestinal impairments. It assesses understanding of nutritional assessment, indications for enteral nutrition, and the benefits of tailored nutritional care. Test your knowledge about these vital healthcare topics and improve your understanding of nutritional interventions.

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