MNT II Final Exam Study Guide Questions And
Answers
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)
>> 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
>> 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
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
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 be used to enhance a standard
formula or multiple nutrients that can be combined to produce complete macronutrient formula
** glutamine as an AA from the pharmacy that can be added into the formula as a boost high protein
drink
Enteral nutrition formula composition ANS >> energy content
>> protein-- intact vs. hydrolysates/peptides vs. AAs
Answers
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)
>> 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
>> 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
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
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 be used to enhance a standard
formula or multiple nutrients that can be combined to produce complete macronutrient formula
** glutamine as an AA from the pharmacy that can be added into the formula as a boost high protein
drink
Enteral nutrition formula composition ANS >> energy content
>> protein-- intact vs. hydrolysates/peptides vs. AAs
