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Chapter 37. Enteral Nutrition

Which of the following statements is NOT true regarding enteral nutrition?

a. Enteral nutrition should be used only if parenteral nutrition is contraindicated in the patient.

b. Enteral nutrition is associated with less glucose intolerance compared to parenteral nutrition.

c. Enteral nutrition is associated with lower rates of infection compared to parenteral nutrition.

d. Enteral nutrition can be used even if the patient is eating by mouth.

Answer a is correct. This statement is not true. In general, enteral nutrition is preferred over parenteral nutrition if the patient’s GI system is functional.

Answer b is incorrect. This statement is true as enteral nutrition is associated with significantly less metabolic complications compared to parenteral nutrition.

Answer c is incorrect. This statement is true as parenteral nutrition is associated with a higher risk of infection compared to enteral nutrition.

Answer d is incorrect. This statement is true as enteral nutrition can be used as a supplement to food when oral intake is insufficient.

While administering medications via nasogastric tubes:

a. The medication must be compatible with basic fluids.

b. Tablets must be fully crushed and mixed with 15 to 30 mL of water.

c. The tube must be flushed with 250 mL of water before and after medication administration.

d. Capsule beads should be crushed and mixed with 15 to 30 mL of water.

Answer b is correct. Tablets that are able to be crushed must be ground into a very fine powder and mixed with water prior to administration.

Answer a is incorrect. The tip of a nasogastric tube terminates in the gastrum of the stomach which is acidic. There is no requirement for compatibility with basic medium.

Answer c is incorrect. Nasogastric tubes should be flushed with 30 mL before and after medication administration.

Answer d is incorrect. Capsule beads should not be crushed. For those capsules that can be opened, the beads should be given intact and flushed with 30 mL water before and after administration.

JK is a 28 yo admitted with seizures secondary to alcohol withdrawal. The medical team starts JK on oral phenytoin regimen of 100 mg three times daily and also initiates the patient on continuous tube feedings since his oral food intake is inadequate at this time to provide optimal nutrition. All of the following counseling points ...

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