Weekly Questions and Reflection #10 (1)
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Feb 20, 2024
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Weekly Questions and Reflection #10
This assignment uses Chapter 16 and 18
Chapter 16 Enteral and Parenteral Nutrition
1.
Comparison
: Identify 4 comparison points: route, risks,
benefits, actual sources of nutrition, types of patients, etc. (2 points)
Enteral Nutrition
Parenteral Nutrition
Route of Nutritional Intake:
The route of intake for enteral nutrition is
through a feeding tube. The feeding tube
can be placed as an NG, gastrostomy,
nasojejunal, or jejunostomy tube.
Route of Nutritional Intake:
The route of intake is through venous access
and is special because it can bypass the Gl
tract. It can be through a central or
peripheral vein.
Transitioning:
For the transition process, it is important to
aim for 6 small oral meals a day. Sometimes
during this stage, it might be necessary to
continue tube feeding
.
Transitioning:
It is only okay for a patient to transition off
PN when the body can have proper function
of the GI. The transition usually leads to
intake through EN or orally once the patient
can do at least 50% of their intake through
another method.
People who have:
This intervention is for patients that cannot
orally consume food, and instead use a tube
to get adequate calories and protein.
People who have:
This is for patients that are malnourished
and who have a problem with using EN. It
can also be used when a patient is lacking
bowel functioning.
Risks of intake:
Some risks are the tube becoming clogged,
irritation at the insertion site and aspiration.
Risks of intake:
It is not the preferred method of intake (EN
is). It can be invasive, costly, and cause
infections. It should never be used for long
periods of time.
2.
Based on reading from page 341-342 describe in your own
words:
(2 points)
Intermittent tube feeding: Feedings that occur in large volumes about
5-8 times a day for 30-45 minutes
Bolus tube feeding: feeding via a syringe that occurs 4-6 times a day
for about 10-20 minutes.
Continuous drip tube feeding: a certain amount of formula that is
typically prescribed that is given at a constant rate that is about 16-24
hours long.
Cyclical feeding: Constant rate of formula that is given over 8-20
hours (typically during sleeping).
3. Skim over the Adult and Pediatric product guides and pages
338-340 in the textbook. Make 2 observations about feeding formulas
or products that you find interesting
. (2 points)
1. Many standard formulas can be consumed as an oral supplement
2. Standard formula variations include high-protein, high calorie, fiber
enriched as well as disease specific formulas.
4. Describe one adult formula and 1 pediatric formula you find
interesting and why.
(2 points)
1. Adult: ENSURE COMPACT THERAPEUTIC NUTRITION is
easy-to-drink in a 4-fl-oz bottle. Providing complete, balanced
nutrition that helps to supplement an individual’s diet when they are
unable to consume an 8 fl oz or volume-limited diet.
For oral use, Ideal for Med Pass, For interim sole-source nutrition.
2. Pediatric: Similac Pro-Advanced: A 20 Cal/fl oz, nutritionally
complete, non-GMO, milk-based, iron fortified standard infant formula
designed to support both immune and cognitive development with
key ingredients found in breast milk. For use as a supplement or
alternative to breastfeeding.
5. Based on readings from page 352, summarize what refeeding
syndrome is and why it could be fatal.
(2 points)
Refeeding syndrome can be defined as the potentially fatal shifts in fluids
and electrolytes that may occur in malnourished patients receiving artificial
refeeding. These shifts result from hormonal and metabolic changes and
may cause serious clinical complications.
Chapter 18
:
Critical Illness
6. Summarize 3 phases of the stress response and any nutrition goals
(Box 18.1).
(2 points)
Phase 1: the body mounts an antiinflammatory response to counter
the proinflammatory response
Phase 2: a disproportionate shift toward an antiinflammatory state
can lead to endothelial damage and organ failure, immune suppression,
metabolic abnormalities, and loss of body mass.
Phase 3: The weakened immune system is unable to destroy
pathogens, and the host becomes increasingly immunocompromised
7. How does the stress response contribute to malnutrition?
(2 point)
Although it is difficult to actually define malnutrition in critically ill clients, it
is estimated to affect 39% to 78% of clients with critical illness
8. How would you summarize table 18.1. Nutrition for Wound Healing
and Recovery if you were talking to a patient about nutrition and
wound healing.
(2 points)
In order to heal properly and recover we need to restore blood volume and
plasma protein along with restoring fluids lost through vomiting,
hemorrhage, etc., and restore normal weight.
9. Jot down points of interest about:
(4 points)
Burns
(pages 398-400)
-
The extensive inflammatory response causes rapid fluid shifts and
large losses of fluid, electrolytes, protein, and other nutrients from the
wound
-
Daily calorie counts may be used to monitor intake
Acute Respiratory Distress
(pages 400-401)
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-
Clients with acute respiratory failure who require fluid restriction may
benefit from calorie-dense EN formulas that provide more nutrition in
less volume than standard formulas
-
Protein requirements generally range from 1.5 to 2.0 g/kg/day