Skills Written Test 2 Study Guide

Calories protein 4kcalg source of energy essential

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calories Protein (4kcal/g)- source of energy. Essential for building of body tissue in growth, maintenance, and repair. Amino acid- simplest form of protein Fats (9kcal/g)- composed of triglycerides and fatty acids EN- enteral nutrition- feedings via nasoenteric/gastrostomy/jejunostomy tubes. Generally started at full strength.
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Full strength- straight out of the can (start here)/ half strength- half water When placing a NG tube, have the patient in Fowlers position. (No lower than 30°) Replace IV food if it has been out >24 hours Check GRV before next feeding (if less than 250ml, put feeding back into pt and flush with water) Measure NG tube from tip of the nose, to the tip of the ear, to the xiphoid process and mark with a piece of tape. NG insertion= clean process, not sterile (as opposed to urinary catheters) Pt may vomit during NG insertion Best way to check if NG tube is in the stomach= Xray (also, may use pH strip to assess pH of gastric juices) PN/TPN- Total parenteral nutrition- IV administration of a complex, higly concentrated solution containing nutrients and electrolytes that is formulated to meet a patient’s needs o CVC- central venous catheter- delivers IV fluid into the superior vena cava o PICC- Peripherally inserted central catheter- catheter tip lies in a vein of one of the extremities Patients who are NPO and receive only standard IV fluids for more than 4-7 days are at nutritional risk GRV- gastric residual volume- If a single GRV volume is >500ml or >250ml each on two consecutive measurements taken one hour apart, then hold feeding Gavage- pt feeding via a tube Gastric decompression- relieving pressure- used to remove gastric contents and relieve associated abdominal distension and decrease patient discomfort Connects to suction for decompression tubes:
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Gastric lavage- irrigating the stomach (most often for removal of toxic meds/poison) MNT- medical nutrition therapy PEG/PEJ- Percutaneous endoscopic gastrostomy/jejunostomy. Inserted endoscopically Surgical/endoscopically placed tubes- long term (>4weeks) Re-feeding syndrome- metabolic disturbances occurring as a result of reinstitution of nutrition to patients who are starved or severely malnourished Silent aspiration- aspiration in patients with neuro problems leading to decreased sensation SPL- speech language pathologist/ Evaluates ability to swallow Enteral (NG) tubes o Levin- for feeding or decompression. Single lumen o Salem Sump- gastric decompression- intermittent suction on low (continuous suction would destroy the gastric lining- set with suction gauge)/ double lumen (one for suction, other for air vent) o Dobhoff- small bore weighted tube- goes to intestines o Small bore (8-12 French) o Large bore (14-16 Fr)- gastric decompression
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Secure NG/EN tubes to patient Gastric Tube (G-tube)- Goes directly into the stomach Kangaroo feeding pump Flush NG tubes before and after feeding High risk for aspiration- decreased levels of alertness, decreased gag/cough reflexes, difficulty managing saliva, pts with dysphagia
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