MNT: ENTERAL NUTRITION QUESTIONS WITH CORRECT ANSWERS |LATEST UPDATE 100%
SOLVED| GRADED A+
Metabolic Complications Causes
Refeeding syndrome in malnourished pt
Insulin deficiency or resistance
Increased nutrient losses
Inadequate delivery of nutrients
Prevention/Tx
Monitor I/O's, weight, glucose, electrolytes, mineral levels
Modify rate or formula type
Major D/V
Refeeding Syndrome - Metabolic alterations that occur during nutritional repletion of
malnourished "starved" patients
- Occurs with shift of electrolytes that occurs with the reintroduction of carbohydrates for fuel
- Drop in Mg, K+, PO4, elevated BG
- Can cause cardiac abnormalities/death
- At risk: malnutrition, long hx of inadequate intake, NPO for several days/weeks
Gastrointestinal Complications Diarrhea, constipation, bloating, gas
Causes
Formula (osmolality, type, infusion rate)
,Malnutrition/malabsorption/dehydration
Medications (antibiotics)
Obstruction/Tube migration
Most common complication is diarrhea!
Not necessarily b/c of tube feedings
Can be caused by meds, if not a lot feed thru it, fiber in formula cannot be soluble or becomes a
gel
If intestinal cells not healthy,
Prevention/Tx for GI complications Modify formula/rate
Change meds
Monitor I/O's
Elevate HOB/check tube placement
Mechanical Complications Causes
Inadequate flushing/positioning/diameter of tube
Prevention/Tx
Good oral hygiene/adequate hydration
Flush tube regularly/avoid meds in tube
Reduce tube size/check proper placement
, Infectious Complications Causes
Contaminated formula/feeding equipment
Use of G tube (vs. J or D tube)
Unclean ostomy site
Prevention/Tx
Monitor gastric residuals/elevate HOB/use J or D tube
Check hang time and changing of feeding equipment
Proper ostomy care
Initiation/Advancement Guidelines Based on clinical judgement and established institutional
protocols
Should be able to reach goal rate within 24-48 hours of initiation
Critically ill: initiated within 24-48 hours of admission and advanced to met prescription within
72 hours
Pts normally start on a lower rate, make sure pts tolerate it
Determining Final Volume Based on assessment of kcals
Daily total kcals/kcal density = goal volume
Goal volume/hours of feeding = goal rate
Determining Free Water Needs Estimate H2O requirement
SOLVED| GRADED A+
Metabolic Complications Causes
Refeeding syndrome in malnourished pt
Insulin deficiency or resistance
Increased nutrient losses
Inadequate delivery of nutrients
Prevention/Tx
Monitor I/O's, weight, glucose, electrolytes, mineral levels
Modify rate or formula type
Major D/V
Refeeding Syndrome - Metabolic alterations that occur during nutritional repletion of
malnourished "starved" patients
- Occurs with shift of electrolytes that occurs with the reintroduction of carbohydrates for fuel
- Drop in Mg, K+, PO4, elevated BG
- Can cause cardiac abnormalities/death
- At risk: malnutrition, long hx of inadequate intake, NPO for several days/weeks
Gastrointestinal Complications Diarrhea, constipation, bloating, gas
Causes
Formula (osmolality, type, infusion rate)
,Malnutrition/malabsorption/dehydration
Medications (antibiotics)
Obstruction/Tube migration
Most common complication is diarrhea!
Not necessarily b/c of tube feedings
Can be caused by meds, if not a lot feed thru it, fiber in formula cannot be soluble or becomes a
gel
If intestinal cells not healthy,
Prevention/Tx for GI complications Modify formula/rate
Change meds
Monitor I/O's
Elevate HOB/check tube placement
Mechanical Complications Causes
Inadequate flushing/positioning/diameter of tube
Prevention/Tx
Good oral hygiene/adequate hydration
Flush tube regularly/avoid meds in tube
Reduce tube size/check proper placement
, Infectious Complications Causes
Contaminated formula/feeding equipment
Use of G tube (vs. J or D tube)
Unclean ostomy site
Prevention/Tx
Monitor gastric residuals/elevate HOB/use J or D tube
Check hang time and changing of feeding equipment
Proper ostomy care
Initiation/Advancement Guidelines Based on clinical judgement and established institutional
protocols
Should be able to reach goal rate within 24-48 hours of initiation
Critically ill: initiated within 24-48 hours of admission and advanced to met prescription within
72 hours
Pts normally start on a lower rate, make sure pts tolerate it
Determining Final Volume Based on assessment of kcals
Daily total kcals/kcal density = goal volume
Goal volume/hours of feeding = goal rate
Determining Free Water Needs Estimate H2O requirement
