Enteral and Parenteral Nutrition Flashcards

Which formula type is most appropriate for a patient with severe malabsorption and short bowel syndrome?

Answer: Elemental (monomeric) formula

Elemental formulas contain nutrients in their simplest absorbable forms (amino acids, monosaccharides, fatty acids), making them ideal for patients with severely compromised digestive and absorptive capacity.

What is the primary indication for using a nasojejunal (NJ) tube instead of a nasogastric (NG) tube?

Answer: High risk of aspiration due to gastroparesis or delayed gastric emptying

NJ tubes bypass the stomach and deliver formula directly into the jejunum, significantly reducing aspiration risk in patients with gastroparesis, gastroesophageal reflux, or impaired gastric motility.

A patient on total parenteral nutrition (TPN) develops refeeding syndrome. Which electrolyte abnormality is the hallmark of this condition?

Answer: Hypophosphatemia

Hypophosphatemia is the hallmark of refeeding syndrome; rapid carbohydrate administration shifts phosphorus intracellularly for ATP synthesis, causing dangerous drops in serum phosphorus.

What osmolality range is generally considered safe for peripheral parenteral nutrition (PPN) to avoid thrombophlebitis?

Answer: Less than 900 mOsm/L

PPN solutions should not exceed approximately 900 mOsm/L to minimize the risk of thrombophlebitis and vein irritation when infusing through a peripheral vein.

Which complication is most commonly associated with long-term parenteral nutrition use?

Answer: Parenteral nutrition-associated liver disease (PNALD)

Parenteral nutrition-associated liver disease (PNALD) is the most common serious long-term complication of PN, characterized by cholestasis, steatosis, and potentially progressing to cirrhosis.

When initiating enteral nutrition in a critically ill patient, what is the preferred delivery site?

Answer: Gastric feeding whenever feasible

Gastric feeding is the preferred initial route in most critically ill patients as it is physiologically normal, stimulates gut hormones, and is easier to initiate; post-pyloric feeding is reserved for those with high aspiration risk.

What is the caloric density of a standard 20% lipid emulsion used in parenteral nutrition?

Answer: 2.0 kcal/mL

A 20% lipid emulsion provides 2.0 kcal/mL; the 10% emulsion provides 1.1 kcal/mL and the 30% emulsion provides 3.0 kcal/mL.