FEN: Enteral Nutrition II Flashcards Preview

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Flashcards in FEN: Enteral Nutrition II Deck (21)
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1
Q

List three lab values that should be monitored with enteral nutrition

A
  1. Blood glucose concentration
  2. Prealbumin weekly
  3. Serum sodium and other electrolytes
2
Q

What is an exception to monitoring prealbumin weekly?

A

Caution in critically ill patients because it reflects acute-phase response rather than nutrition status

3
Q

List four non-lab value parameters that should be monitored with enteral nutrition

A
  1. Head of bed elevation
  2. GI tolerance
  3. Wound healing
  4. Other medications that add additional calories
4
Q

To what degree should head of bed be elevated to prevent enteral feeding aspiration?

A

30-45 degrees

5
Q

List three parameters or signs/symptoms that can be monitored to check for GI tolerance to enteral feedings

A
  1. Abdominal pain or distension
  2. Stool frequency and volume
  3. Nausea, vomiting and diarrhea
6
Q

Checking ___________ is not recommended to determine GI tolerance of EN

A

Gastric residuals

7
Q

List two medications that add additional calories that require EN rates to be adjusted

A
  1. Propofol

2. Clevidipine

8
Q

Diarrhea can occur with medications having a high _______

A

Osmolality (e.g. medications mixed in sorbitol)

9
Q

____ formulations for drug administration using enteral access, but they should be ____

A

Liquid, but they should be diluted

10
Q

Describe how to dilute liquid medications for enteral access

A

They should be diluted with 2-3 times the medication volume with water

11
Q

How to flush feeding tube for drug administration?

A

Flush with 20 mL of water before and after each drug administered

12
Q

What two types of pill formulations, in general, should not be crushed?

A
  1. Sustained release

2. Enteric coated

13
Q

How to administer a tablet by feeding tube?

A
  1. Mix crushed tablets or capsule contents with 10-15 mL of water
  2. Administer each drug separately
14
Q

What may be done to prevent reduced bioavailability for certain drugs when administered with enteral access?

A

Discontinue tube feedings before and after drug administration temporarily

15
Q

List four drugs for which discontinuing tube feedings before and after drug administration temporarily is common

A
  1. Fluoroquinolones
  2. Phenytoin
  3. Warfarin
  4. Bisphosphonates
16
Q

Give an example of when considering feeding tube location is important when administering drugs with enteral access

A

Antacids need to be administering into the stomach, not the duodenum

17
Q

List five general steps in developing an EN regimen

A
  1. Determine caloric requireements
  2. choose a formula and assess calories per millileter
  3. Determine infusion rate
  4. Ensure that the patient will receive sufficient protein
  5. Ensure that the patient will receive about 30 mL/kg/day of water
18
Q

In general, what is a typical caloric requirement range?

A

25-35 kcal/kg/day

19
Q

In general, what is a typical protein requirement range? Who does this exclude?

A
  1. 8-2 g/kg/day
  2. Changes based on BMI (i.e. obesity)
  3. And burns/trauma
20
Q

How to calculate the infusion rate?

A
  1. Determine the total volume of EN nutrition by using the kcal/mL of the selected EN formula and the total caloric requirements
  2. Divide that total volume over 24 hours
21
Q

How to ensure the patient is receiving enough water with their EN feedings?

A
  1. Product information will give the water content
  2. Calculate the amount of free water given with the volume of EN feedings, and find the additional water required compared to 30 mL/kg/day.
  3. Administer as water flushes through feeding tube every 4-6 hours.