Chapter 16- Enteral and Parenteral Nutrition (Rachel)

What is a hydrolyzed formula?

Fiber free, amino acids, broken down fats and carbs

What patients would need to be on a hydrolyzed formula?

Impaired GI status

What are the requirements for PN administration?

Check bag for precipitate, expiration date, confirm administration site, confirm PN order, compare order and label.

What should you do if PN has been discontinued?

Initiate IV fluids

Why are IV fluids needed?

To prevent hypoglycemia

What is the difference between hydrolyzed and standard formulas?

Hydrolyzed is broken down.

What are the common causes for diarrhea in EN?

Medications, temperature of formula, TF rate or position, osmolarity.

What cannot be used in a J-tube?

Bolus administration because of diarrhea

What does a J-tube require?

Infusion pump

What does a J-tube reduce?

Aspiration risk

What are the flushing guidelines?

Before and after meds. 30-60 mLs.

What is cyclic feeding?

Provides nutrition intermittently, allowing some normal intake. Nocturnal feeding.

What is a continuous drip reduce and where?

Aspiration risk, particularly when delivered to the intestines.

What is fat/lipid PN used for?

To prevent fatty acid deficiency, avoid hypertriglyceridemia.

What is SMOF lipid?

A source of calories and essential fatty acids that is injected intravenously when a patient cannot receive food orally or enterally.

What indicates parenteral nutrition is needed?

When the GI tract is not functional.

What health complications would be examples of a non-functional GI tract?

Malabsorption, Prolonged ileus, Ischemia/thrombosis, Intestinal fistula, Short Gut Syndrome, Small or large bowel obstructions, pseudo obstructions.

What causes refeeding syndrome?

Electrolyte shifts

What electrolytes need to be monitored for refeeding syndrome?

Mg, PO4, K

What can be used in a SMOF lipid?

Olive oil, medium chain triglycerides, soybean oil, fish oil.

What needs to be done in order for a tube feed to be initiated?

Confirm tube feed tip placement

Where does a PICC line go?

Into the heart of

What are the two lines used in parenteral nutrition?

Central and Peripheral

When do you need to use a central line?

Higher osmolarity.