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Chapter 101. Enteral Nutrition

Student Questions

Which of the following best describes EN for patients with renal dysfunction?

A. Products used in this population generally have low caloric density.

B. Products used in this population generally have lower amounts of magnesium compared with standard EN products.

C. Products designed for patients receiving dialysis are generally relatively low in protein.

D. Formulas enriched with essential amino acids are the most commonly used products in this population.

Answer: B

Option A: Incorrect. Products for patients with renal dysfunction often have high caloric density, especially those products designed for patients not receiving dialysis.

Option B: Correct. Magnesium, potassium, and phosphorus are primarily excreted renally and are thus often provided in lower amounts in renal formulas compared to standard products.

Option C: Incorrect. Protein provision can be liberalized when patients go on dialysis, therefore products designed for these patients are relatively high in protein.

Option D: Incorrect. Although formulas enhanced with essential amino acids were promoted in the past for patients with renal insufficiency, they are uncommonly used today.

An 81-year-old man is on long-term EN because of dysphagia following a cerebrovascular accident. He has comorbidities of congestive heart failure, hypertension, and hyperlipidemia. Which of the following describes best practice for tube care and delivery of medication down the patient's tube?

A. The best fluid for flushing feeding tubes is diet soda.

B. When administering medications through the feeding tube, 15 mL of water should be used as a flush between medications.

C. Antacids should routinely be placed down jejunal tubes to reduce symptoms of gastroesophageal reflux disease.

D. Tube feedings should be stopped for 1 hour before and 1 hour after tube administration of most medications.

Answer: B

Option A: Incorrect. Although alternatives such as soda or juice have been commonly utilized to flush feeding tubes, the preferred fluid is warm water.

Option B: Correct. Flushing with water between administered medications may help to prevent drug interactions and tube occlusion.

Option C: Incorrect. Antacids work locally in the stomach to neutralize acid. Administering them directly into the jejunum bypasses their primary site of action, rendering them ineffective.

Option D: Incorrect. Although certain medications may be better absorbed when the tube feeding is held before and after administration, this is not the routine practice with most medications.

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