Exam 15: Enteral and Parenteral Nutrition Support

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A formula that approximates the osmolality of normal blood serum:

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Name and discuss five metabolic complications that may result from parenteral feedings.

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Mr. Avery is a 77-year-old retired engineer. He is 5'10" tall and weighs 171 pounds. He suffered a stroke, which left him with left-sided paralysis, and he is having difficulty swallowing so he is unable to meet his nutritional needs via oral intake at this time. Mr. Avery's swallowing ability and oral intake are improving. He is now consuming about 2/3 of his estimated nutrient needs from oral intake. It would be appropriate at this time to:

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Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with: End-stage adenocarcinoma of the gastroesophageal juncture. Chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting. Acute pancreatitis with intractable vomiting. Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery. Meds: antilipemic medication, antihypertensive medication. Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s. Ht: 5'8". Admission Wt: 107 lbs. Usual Wt, 1 year ago: 170 lbs. Social Hx: Lives alone; cooks and shops for himself despite illness. Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet. Mr. Edward is not being actively treated for cancer at his request. A peripheral line for hydration and nutrition support has been inserted. Which parenteral infusion complication is Mr. Edward at risk of developing?

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What describes an advantage of using a closed system for delivering enteral feedings?

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Types of formulas that contain intact proteins are called:

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Dietary treatment of galactosemia depends primarily on the elimination of:

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Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with: End-stage adenocarcinoma of the gastroesophageal juncture. Chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting. Acute pancreatitis with intractable vomiting. Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery. Meds: antilipemic medication, antihypertensive medication. Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s. Ht: 5'8". Admission Wt: 107 lbs. Usual Wt, 1 year ago: 170 lbs. Social Hx: Lives alone; cooks and shops for himself despite illness. Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet. Mr. Edward is not being actively treated for cancer at his request. A peripheral line for hydration and nutrition support has been inserted. The nutrition support team determines how much carbohydrate, protein, fat, vitamins, minerals, and fluid they will administer to Mr. Edward. What component of Mr. Edward's peripheral nutrition infusion will provide the greatest number of kcalories in the smallest volume of fluid?

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Differentiate between the characteristics and uses of standard formulas and hydrolyzed formulas.

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Long-term TPN administration may result in complications such as:

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The dextrose monohydrate used in parenteral nutrition solutions provides _____ kcal/g.

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What type of enteral formulas are made from whole foods and derive their protein primarily from pureed meat?

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What action would most likely prevent refeeding syndrome in a malnourished patient? 

(Multiple Choice)
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Mr. Stanley Edward, a 58-year-old African American male, was admitted to the emergency room of the medical center and resuscitated after being found unconscious in his car in a parking lot. His history was obtained by contacting his daughter. The patient presents with: End-stage adenocarcinoma of the gastroesophageal juncture. Chronic malnutrition and significant weight loss × 1 year. Low BMI, loss of muscle, loss of subcutaneous fat, bitemporal wasting. Acute pancreatitis with intractable vomiting. Medical Hx: Hypertension; S/P stroke @ age 56; cataract surgery. Meds: antilipemic medication, antihypertensive medication. Hx: Lifelong chain smoker (2 packs per day); alcohol abuse since his late 20s. Ht: 5'8". Admission Wt: 107 lbs. Usual Wt, 1 year ago: 170 lbs. Social Hx: Lives alone; cooks and shops for himself despite illness. Dietary Hx: Previously followed a low-cholesterol, low-sodium, high-potassium diet. Mr. Edward is not being actively treated for cancer at his request. A peripheral line for hydration and nutrition support has been inserted. Mr. Edward's blood glucose level rises to 350 mg/dL. What response from the health care team is most appropriate?

(Multiple Choice)
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Infants diagnosed with galactosemia are given formulas that do not contain:

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Parenteral nutrition can be discontinued when _____ of estimated energy needs are being met by oral intake, tube feeding, or a combination of the two.

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Nursing Exam Review Multiple Choice The nurse is working with a patient who requires a tube feeding but who would like to return to work and resume other activities. What is the best way to feed this patient?

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Highly concentrated nutrient solutions are not suitable for peripheral parenteral nutrition.

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What describes an advantage of using a nasogastric tube to provide enteral tube feedings?

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Before discontinuing a tube feeding, the patient's oral intake should meet about _____ of estimated nutrient needs.

(Multiple Choice)
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