Nutritionally complete formulas are delivered through a tube placed directly into the GI tract, distal to the oral cavity.
Used when a patient is unable to eat but may be able to digest foods and absorb nutrients normally correct answersTube Feedings
nutrition support is generally provided by...
Nutritionally complete formulas are delivered through a tube placed directly into the GI tract, distal to
the oral cavity.
Used when a patient is unable to eat but may be able to digest foods and absorb nutrients normally
correct answersTube Feedings
nutrition support is generally provided by members of the NUTRITION SUPPORT TEAM correct
answersNutrition Support
USUAL SUPPORT TEAM MEMBERS AND QUALIFICATIONS
Certified Nutrition Support Clinician (CNSC)
Pharmacist - PharmD
Dietician - RD correct answersNutrition Support Team
all cases must be assessed for risk versus benefit correct answersIndications for Tube Feeding
Consider a TF if it is a bridge to improve your patients long term status
Often, you do not know yet
They may recover from the stroke or MVA
If adequate time has passed with no improvements then its no longer a bridge to anything better.
When reaching end of life decisions the MD may offer TF when it is not going to improve the patients
health correct answersEthical Decisions in TF
If the gut works, use it
Must have at least 100 cm of small bowel correct answersIndications for Tube Feeding
At high risk for malnutrition due to a hypermetabolic state induced by major burns, trauma, surgery,
sepsis etc correct answersHYPER METABOLIC STATES/HIGH NEED
,(Indications for Tube Feeding)
Poor appetite/anorexia due to coma or severe neurological problems, depression, anorexia nervosa,
dementia/Alzheimer's, cancer cachexia, chemotherapy, radiation therapy correct answersANOREXIC
DISORDERS/INABILITY TO EAT
(Indications for Tube Feeding)
an abnormal connection between an organ, vessel, or intestine and another structure.
are usually the result of injury or surgery. It can also result from infection or inflammation correct
answersFistula
Complete mechanical bowel obstruction
Less than 10% of the SI or severe damage to most of the SI
Severe diarrhea
Acute bowel ischemia
Severe total ileus
High output fistula
Severe acute pancreatitis correct answersContra-Indications for Tube Feeding
The prognosis does not warrant aggressive treatment and patient's death is imminent
Generally avoid feeding into the stomach in severe gastritis or active bleeding ulcers
Right of self determination- a competent patient refuses to be tube fed correct answersContra-
Indications for Tube Feeding
Lower serious complication rate
Less hyperglycemia, sepsis etc.
Solutions and equipment do not have to be sterile
, Stimulates the GI tract and helps maintain gut mass, integrity, hormonal balance, mucosal enzymes such
as dissaccharidases and peroxidases and nutrient utilization correct answersAdvantages
AS COMPARED TO Parenteral Nutrition
artificial opening created by surgical procedure correct answersSurgically Placed Tubes
GI Access
"Ostomy"
Access route described by where it enters the body and where the tip is located correct
answersNasogastric (NG)
Orogastric
Nasointestinal
Surgically Placed Tubes
Can't feed into the stomach if gastric decompression is needed or patient is vomiting
Do NOT place a gastric tube if recent gastric or esophageal surgery or no gag reflex correct
answersGastronomy Disadvantages
Advantages
Really little
Disadvantages
Harder to place and easily dislodged (typically moving back into the stomach) correct answersDuodenal
Tubes
Needle catheter- often the catheter or small feeding tube is placed through a needle into the SI during
surgery of via a laporatomy
Surgical jejunostomy- similar to gastric procedures except the tube is smaller and is placed in the SI
Percutaneous endoscopic jejunostomy (PEJ)- procedure is similar to a PEG correct answersJejunostomy
Tube
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