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Question Answer
Hyperglycemia from enteral nutrition occurs because compromised _______ function that increases digestive enzymes leads to complex carbohydrate digestion.
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exocrine
Hyperglycemia from parenteral nutrition occurs because of compromised _______ function and the resultant decreased insulin production.
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endocrine
Formula for open systems can be kept at room temperature for up to _______.
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12 hours
Closed system formula can be used for at least _______.
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24 hours
Which drugs are known to result in drug nutrient interactions when given enterally?
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Phenytoin/Dilantin, Warfarin/Coumadin, Cipro, Carbidopa-levodopa/Sinemet, iron, and K+.
_______ nutrition includes amino acids which can indirectly stimulate gastric acid secretions which can increase pancreatic secretions.
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Parenteral
What are the recommendations for checking ET patency to minimize the risks of contamination?
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Flush with 30 mL of water, aspirate, flush again, and check every 4-6 hours for those on continuous feeds, right before feed if intermittent.
When administering medications enterally, how should they be prepared?
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Crush them to a fine powder, mix with 30 mL of water, wash port with alcohol, administer the medication (with gloves on), and flush the port, clean with alcohol.
Which type of nutritional support is most likely to cause hyperglycemia?
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Parenteral
ACG recommends patients with necrotizing pancreatitis should be given _______ daily to decrease the risk of duodenal ulcers.
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Proton Pump Inhibitors
What type of enteral formulas should be avoided?
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Formulas that require dilution, reconstitution or additions.
For formulas that require mixing or additions, what are the recommendations for preparation?
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Aseptically prepared by dietary department; Use tap H2O if safe, sterile if critically ill/immunocompromised; Assemble on a surface disinfected with 70% isopropyl alcohol, disinfect rim of can and bag opening; Store in fridge for less than 24 hours.
What actions are recommended to decrease provider-related enteral feeding contamination?
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Wash hands/alcohol-rub (10 sec) prior, wear gloves, and wear mask if you have a cold or URI.
What practices have been shown to reduce enteral exogenous contamination?
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Use a closed system, wash hands and prep surface prior to preparing, and wear gloves.
What feeding system design characteristics are recommended to decrease contamination?
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Closed system, decrease connections, and have medication ports.
What are the don'ts of enteral feeding?
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Don't touch any part that will touch formula, don't have numerous connections, don't reuse or use past expiration date, and don't add formula.
What are the complications associated with enteral feeding?
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Diarrhea, infection, sepsis, pneumonia, longer hospital stays, and death.
_______ nutrition encourages the rapid return of normal gut function and decrease cytokine generated stress responses of pancreatitis.
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Enteral
What should occur 48 hours after hospital admission for a patient with mild to moderate acute pancreatitis?
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Reassessment of inflammatory stress markers.
What effect does tube feeding have on gastric ph?
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Results in gastric alkalinization (pH over 3.5) which increases risk of infection.
How does endogenous contamination of enteral feedings occur?
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Retrograde process, aspirating gastric contents, removing the guide wire, and blue food dye.
_______ nutrition can result in gastric stimulation which causes the gut to stimulate the release of pancreatic enzymes.
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Enteral (triggered by tube migration)
_______ nutrition can cause bacterial translocation from the gut, leading to infection.
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Parenteral
What are common complications associated with parenteral nutrition?
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Sepsis, infection, and hyperglycemia.
Immediately prior to administration of an enteral feeding, what can be done to decrease the risk of contamination?
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Disinfect the ports with 70% isopropyl alcohol before and after.
What are the ACG's recommendation regarding when to use parenteral nutrition?
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When enteral nutrition isn't tolerated.
ACG guidelines recommend _______ nutrition as the 1st route of nutritional support when warranted for acute pancreatitis.
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enteral
Patients with malnutrition and severe acute pancreatitis should have enteral nutrition within _______ of admission.
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48 hours
Patients given _______ nutrition require fewer days of nutritional support and progress to an oral diet more rapidly.
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Enteral
What 3 basic interventions promote appetite?
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Environment free of odors, maintain oral hygiene, and maintain comfort.


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