CDN Enteral & Parenteral Nutrition Flashcards

Which complication is most associated with rapid advancement of enteral tube feeding in a critically ill patient?

Answer: Aspiration pneumonia

Aspiration pneumonia is a major risk of enteral feeding, particularly with gastric feeds in patients with impaired gastric motility or altered consciousness.

A patient's TPN order includes 25% dextrose, 10% amino acids, and 20% lipid emulsion. Which component provides the most calories per gram?

Answer: Lipid emulsion

Lipid emulsions provide 9 kcal/gram, compared to dextrose at 3.4 kcal/gram (in IV form) and amino acids at 4 kcal/gram.

Which lab value is most important to monitor for hepatic complications in a patient on long-term PN?

Answer: Serum bilirubin and liver enzymes (ALT/AST)

Elevated bilirubin and liver enzymes indicate PN-associated liver disease (PNALD), a common complication of long-term parenteral nutrition.

For a patient with high gastric residual volumes on tube feeds, what feeding strategy is most appropriate?

Answer: Switch to post-pyloric (jejunal) feeding

Post-pyloric feeding bypasses the stomach, reducing aspiration risk in patients with delayed gastric emptying and high residual volumes.

What is the typical protein requirement (g/kg/day) for a critically ill patient receiving nutrition support?

Answer: 1.2–2.0 g/kg/day

Critical illness increases catabolism and protein needs; ASPEN and SCCM guidelines recommend 1.2–2.0 g/kg/day for most critically ill adults.

Which electrolyte abnormality is most commonly associated with initiating PN in a patient who has been NPO for an extended period?

Answer: Hypophosphatemia

Hypophosphatemia is the hallmark of refeeding syndrome, occurring when carbohydrate infusion drives phosphorus into cells during anabolic activity.