MNT 2 Exam 3 Questions And Answers With Verified
Solutions
nutrition support ANS delivery of formulated enteral or parenteral nutrients to maintain or restore
nutritional status
enteral or parenteral
enteral nutrition ANS provision of nutrients into the GI tract through a tube or catheter when oral
intake is inadequate
may include formulas as oral supps or meal replacements
functional GI tract
for those who can't eat or can't eat enough, evidenced by calorie count
should be 1st consideration
parenteral nutrition ANS provision of nutrients intravenously (last resort)
insufficient GI tract function or no access
TPN
- hyperglycemia
- gut atrophy
- stress on the liver
- 7 days
benefits of enteral vs parenteral nutrition ANS better GI barrier function
,preserved GI immunity
attenuate catabolic response
better blood glucose control
decreased rates of infection
#1 most common TPN complication ANS hyperglycemia
what conditions often require enteral nutrition? ANS impaired nutrient ingestion (dysphagia,
neurologic disorders, facial trauma, oral or esophageal trauma, congenital abnormalities, respiratory
failure, cystic fibrosis, dementia, failure to thrive, burns, cancer)
impaired digestion, absorption, metabolism (severe gastroparesis)
enteral nutrition access depends on... ANS anticipated length of time of enteral feeding (temp
NGT / OGT vs PEG)
risk for aspiration or tube displacement
clinical status
presence / absence of normal digestion and absorption
planned surgical intervention (post pyloric sometimes anchored by IR / GI so doesn't migrate)
enteral nasogastric route ANS short term: up to 3 or 4 weeks
,normal GI function
bolus, intermittent, or continuous infusions
can still take PO if appropriate
enteral nasoduodenal / nasojejunal route ANS short term: up to 3 or 4 weeks
gastric motility disorders, esophageal reflux, persistent nausea and vomiting
aspiration risk, gastroparesis, hyperemesis gravidarum
enteral percutaneous gastrostomy / jejunostomy (PEG / PEJ) ANS nonsurgical technique
preferred for longer than 3 - 4 weeks
minimally invasive enteral techniques ANS laparoscopic or fluoroscopic
multiple lumen tubes (prolonged GI decompression and small bowel feeding)
PEG: can bolus
PEJ: bolus feeds contraindicated (still cycle or intermittent feed)
standard formula ANS jevity
elemental or semi elemental formula ANS peptamen, vital
, fiber free / low osmolality formula ANS osmolite
specialty or disease specific formula ANS nepro
blenderized formula ANS nestle compleat
choosing an enteral formula ANS nutrient requirements
clinical status and GI function
caloric and protein density
form and amount of protein, fat, carb, and fiber in formula
electrolyte content
cost effectiveness
patient compliance
standard polymeric formulas ANS lactose free
1, 1.2, 1.5, or 2 kcal / mL
balanced carb, fat, and protein
contain fiber
meet 100% DRI for micronutrients at ~1 L
Solutions
nutrition support ANS delivery of formulated enteral or parenteral nutrients to maintain or restore
nutritional status
enteral or parenteral
enteral nutrition ANS provision of nutrients into the GI tract through a tube or catheter when oral
intake is inadequate
may include formulas as oral supps or meal replacements
functional GI tract
for those who can't eat or can't eat enough, evidenced by calorie count
should be 1st consideration
parenteral nutrition ANS provision of nutrients intravenously (last resort)
insufficient GI tract function or no access
TPN
- hyperglycemia
- gut atrophy
- stress on the liver
- 7 days
benefits of enteral vs parenteral nutrition ANS better GI barrier function
,preserved GI immunity
attenuate catabolic response
better blood glucose control
decreased rates of infection
#1 most common TPN complication ANS hyperglycemia
what conditions often require enteral nutrition? ANS impaired nutrient ingestion (dysphagia,
neurologic disorders, facial trauma, oral or esophageal trauma, congenital abnormalities, respiratory
failure, cystic fibrosis, dementia, failure to thrive, burns, cancer)
impaired digestion, absorption, metabolism (severe gastroparesis)
enteral nutrition access depends on... ANS anticipated length of time of enteral feeding (temp
NGT / OGT vs PEG)
risk for aspiration or tube displacement
clinical status
presence / absence of normal digestion and absorption
planned surgical intervention (post pyloric sometimes anchored by IR / GI so doesn't migrate)
enteral nasogastric route ANS short term: up to 3 or 4 weeks
,normal GI function
bolus, intermittent, or continuous infusions
can still take PO if appropriate
enteral nasoduodenal / nasojejunal route ANS short term: up to 3 or 4 weeks
gastric motility disorders, esophageal reflux, persistent nausea and vomiting
aspiration risk, gastroparesis, hyperemesis gravidarum
enteral percutaneous gastrostomy / jejunostomy (PEG / PEJ) ANS nonsurgical technique
preferred for longer than 3 - 4 weeks
minimally invasive enteral techniques ANS laparoscopic or fluoroscopic
multiple lumen tubes (prolonged GI decompression and small bowel feeding)
PEG: can bolus
PEJ: bolus feeds contraindicated (still cycle or intermittent feed)
standard formula ANS jevity
elemental or semi elemental formula ANS peptamen, vital
, fiber free / low osmolality formula ANS osmolite
specialty or disease specific formula ANS nepro
blenderized formula ANS nestle compleat
choosing an enteral formula ANS nutrient requirements
clinical status and GI function
caloric and protein density
form and amount of protein, fat, carb, and fiber in formula
electrolyte content
cost effectiveness
patient compliance
standard polymeric formulas ANS lactose free
1, 1.2, 1.5, or 2 kcal / mL
balanced carb, fat, and protein
contain fiber
meet 100% DRI for micronutrients at ~1 L
