MNT II Final Exam Study Guide with Complete Solutions

©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 1/43 MNT II Final Exam Study Guide with Complete Solutions When is enteral nutrition used? - Ans:-WHEN THE GUT WORKS, USE IT! What are the advantages of enteral nutrition? - Ans:- cost-effective reduced infection-related complications improved wound healing reduced surgical interventions maintenance of GI function often times a shorter length of stay What is enteral nutrition? - Ans:-Feeding through the GI tract via a tube, catheter, or stoma that delivers nutrients beyond the oral cavity How can the GI tract be accessed when utilizing enteral nutrition? - Ans:- nasogastric nasoduodenal tube (NDT)/nasojejunal tube (NJT) ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/43 percutaneous endoscopic (PEG) other minimally invasive techniques (high resolution video cameras, fluoroscopy) multilumen tubes-- combination of two tubes (one small one inside a larger one) that can be used to decompress GI and release gas and distention Why do you want to ensure that the tip of the catheter ends up where it needs to be? - Ans:-This is especially important if you are using complete proteins and intact nutrients, you want to go into the stomach and not the duodenum to avoid issues with the gut Enteral Nutrition formula classifications and selections - Ans:-1. Standard 2. Chemically defined (elemental) more specific in that you could have a formula where you add AAs or you add omega-3s to boost the nutrient profile of the formulation vs. polymeric where everything is in its intact form going into the stomach 3. Specialized ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/43 are you going to the stomach? duodenum? jejunum? if you have renal disease, high protein formula to get all of the essential AAs Considerations for formula choice are based on substrate content (protein, fat, and carbohydrate), nutrient density, osmolality, and viscosity Enteral Nutrition, Parenteral Nutrition & Osmolality, Osmolarity Which goes with which? - Ans:-Enteral Nutrition-- osmolality Parenteral Nutrition-- osmolarity (volume based) How do concentrated and partially hydrolyzed formulas impact osmolality? - Ans:-Formulas of these sorts of /= 1.5 cal/mL will have higher osmolality What happens when you increase energy to volume ratio by adding modular components to a formula? - Ans:-This will increase the osmolality of the formula An isotonic product has osmolality = 300 mOsm/kg water ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/43 Enteral formula osmolality ranges from 300-700 mOsm/kg What are the effects of formula osmolality on fluid shifts in the gut? - Ans:-If the number of solute particles in the gut are equal to the solute particles in the vascular system, then there shouldn't be any fluid shifts If you bring in individual AAs rather than intact proteins, the more solute particles there will be and osmolality in the gut will increase, ultimately leading to fluid shifts. Thinking about lactose intolerance-- often times there are too many solutes in the gut and you will experience an osmolality that exceeds what is in the blood, fluids will shift into the gut to try to dilute the greater concentration (mOsm) and patients will experience diarrhea and dehydration What is a saline solution? - Ans:-An isotonic solution that provides a way to rehydrate patients as it wont disrupt the osmolality of the circulation Polymeric Formulas (standard) - Ans:-Requires normal digestive and absorptive capacity, is lactose free Partially Hydrolyzed ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/43 OR Elemental/Defined Formulas - Ans:-Readily absorbed nutrients and low residue (without fiber) ** low residue-- when formula is digested and absorbed, there is nothing left in the gut Disease Specific Formulas - Ans:-Designed for specific nutrient needs caused by injury or disease ** glutamine-- essential AA to the gut, but nonessential AA since we don't need to have them in the diet Modular Formulas - Ans:-Consist of single nutrients that can b