General
This tool helps identify malnourished patients and is a part of the admission navigator.
What is a the Nutrition Screening Tool (NST)?
Feed should be held for this duration before and after administering any medication that needs to be administered on an empty stomach.
What is 15 minutes before and after?
The reason why the PN solution is yellow
What is the addition of a multivitamin solution (Vitamin B complex)?
The appropriate syringe size when flushing any feeding tube.
What is 50cc or larger?
The reason why recording the intake percentages is essential.
What is because the Dietitians and Diet technicians review them to ensure the patient is receiving adequate nutritional support?
Are the benefits of enteral nutrition comparable to parenteral nutrition
What are:
* Maintains gut integrity and prevents atrophy
* Reduces the risk of infection
* More cost-effective
The difference between TPN and PPN solutions
What is the Dextrose final concentration (less than 5% for PPN, 5%-20% for TPN)?
The acronym PEG stands for
Percutaneous Endoscopic Gastrostomy
What MedPass entails at TOH
What is 60ml Resource 2.0 QID?
These are signs and symptoms of intolerance to feeding
What are increased gastric residual, regurgitation, nausea, vomiting, aspiration, gastric bloating, acutely distended abdomen, diarrhea, and pain?
The frequency at which the patient's weight should be recorded when receiving PN.
What is before administration and weekly?
Potential signs of partial tube dislodgement (PEG, PEJ, G-tube)
What are:
* Decrease in the number on tube at skin level (below bolster).
* Bumper is visible.
* Pain associated with the administration of fluids, flushes or formula via an enteral feeding tube.
* Leaking from the insertion site.
* Increase in abdominal girth/distension.
Patients who are appropriate for MedPass
What are patients who are:
* At risk for malnutrition
* eating less than 50% for 3 days or more
* patients with unplanned weight loss
The following types of capsules/tablets should never be crushed.
What are sustained-release, sublingual, buccal, enteric-coated, or cytotoxic capsules/tablets?
Pharmacy requires all orders for PN to be entered into EPIC before this time to receive the TPN at 2100
What is 1300?
The correct actions if a newly inserted tube with a new tract/stoma (0-2 weeks) is dislodged
What are
* Stop feeds immediately, do not use the tube.
* This is an emergency, call the inserting service stat. The patient needs to be assessed within 3 hours.
* Do not attempt to reinsert tube.
Patients who are not appropriate for MedPass
What are patients:
* On mild/moderate thickened fluids
* NPO
* Allergies to milk (whey), corn, or soy
The correct actions if the GRV is 450ml
* Hold the feeds for 2hrs
* Reinstill up to 400ml if asymptomatic
* Reassess GRV 2hrs after if more than 250ml then stop feeds and notify MD, RD. If less, resume feeds.
Possible complications of PN (3/4)
What are:
•Glucose Abnormalities
•Hepatic dysfunction
•Electrolyte imbalances
•Volume overload
The correct actions if a tube that is greater than 4 weeks in maturity (mature tracts) is dislodged
What are:
* Stop feeds immediately, do not use the tube.
* Call the attending service to insert a Foley® to keep the insertion site open. Do not feed, flush or administer medications through the Foley® catheter.
* Notify the inserting service to insert a replacement tube.