Flashcards in Specific feeding needs Deck (22)
surgical opening into the neck for feeding tube into the stomach
Functional GI tract; 1.0 kcal/mL or 1.5 kcal/mL for wt gain
Fiber containing formula
Constipation or bowel disorders
High protein/nitrogen formula
catabolic state, wound healing, etc.
Calorie dense formula
partially functional GI tract
Disease specific formula
Diabetes, hepatic, immune support, metabolic stress, pulmonary, renal, etc.
Diarrhea - vol overload (change to drip if doing bolus)
Nausea - too fast delivery (decrease rate, advance as tolerated) or positioning (position on R side to aid in passage through the pylorus); positioning: aspiration (elevate pt head)
Constipation - dehydration (increase fluids) or lack of fiber (consider higher fiber formula)
Bacterial contamination risk - reduced by using a closed enteral formula system
TPN Sol'n breakdown
Dextrose - 3.4 kcal/g
AA (~12-15% kcal) = 4 kcal/g
Lipids (~30% kcals) = 10% fat = 1.1 kcal/mL; 20% fat = 2 kcal/mL; 30% = 3 kcal/mL
Ca = 0.2-0.3 mEq/kg
Cl = equal to Na
K = 1 mEq/kg
Na = 1-2 mEq/kg
Glucose oxidation rate
GIR OR CHO load; ~5 mg/kg/min for catabolic state; 5-7 mg/kg/min for stable patients.
Glucose oxidation rate: calculations
Grams of Dextrose per day = (kg x desired GOR x 1440 min)/1000
GOR = [(grams CHO x 1000 mg/g)/kg]/1440 min
(mg/atomic weight) x valence
Ca, 40, 2
Cl, 35.4, 1
K, 39, 1
Na, 23, 1
EN: Meds of concern
Fluoroquinolones: bioavailability reduced. Feeding held for one hour before and two hours after medication.
Phenytoin - possible food/drug interaction. Feedings held 1-2 hours before and after meds.
Propofol - used for sedation; 10% fat emulsion.
Low residue diet
High fiber foods plus milk and potatoes
Fecal fat test (meals)
Eat 100 g of fat per day for 3 days before stool collection. Collect for 3 days while maintaining the 100 g intake.
Glucose tolerance test
Blood sample; 75 g CHO, blood sample
Adaptive equipment: Angled utensils
limited arm or wrist movement; spoon or fork is angled toward the mouth
Adaptive equipment: Built-up handles (utensils)
decreased hand strength; handles are larger than normal sized utensils
Adaptive equipment: weighted utensils
poor hand and arm movement away from the body
Adaptive equipment: scoop dishes
raised sides on plate assisted with scooping motion
Adaptive equipment: dycem place mat
poorly controlled arm and hand coordination; skid resistant material useful for adaptive utensils