Questions and Answers 100% Pass
When is enteral nutrition used? - ✔✔WHEN THE GUT WORKS, USE IT!
What are the advantages of enteral nutrition? - ✔✔>> 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? - ✔✔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? - ✔✔>> nasogastric
>> nasoduodenal tube (NDT)/nasojejunal tube (NJT)
>> percutaneous endoscopic (PEG)
>> other minimally invasive techniques (high resolution video cameras, fluoroscopy)
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,>> 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? -
✔✔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 - ✔✔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
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,Enteral Nutrition, Parenteral Nutrition & Osmolality, Osmolarity
Which goes with which? - ✔✔Enteral Nutrition-- osmolality
Parenteral Nutrition-- osmolarity (volume based)
How do concentrated and partially hydrolyzed formulas impact osmolality? -
✔✔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? - ✔✔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? - ✔✔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
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, 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? - ✔✔An isotonic solution that provides a way to rehydrate
patients as it wont disrupt the osmolality of the circulation
Polymeric Formulas (standard) - ✔✔Requires normal digestive and absorptive capacity,
is lactose free
Partially Hydrolyzed
OR
Elemental/Defined Formulas - ✔✔Readily absorbed nutrients and low residue (without
fiber)
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