Nutritional support

Question 1

Name the types of nutritional support

Answer 1

Oral
NG or NJ tube
Feeding gastrostomy (PEG) or jejustomy 
Total parental nutrition
Central total parental nutrition

Question 2

When would you use a nasojejunal tube?

Answer 2

When nasogastric is not possible - severe vomiting, gastric outlet obstruction, gastric resection

Question 3

When would you use TPN?

Answer 3

When oral and NG/NJ is not possible (extensive bowel resection)

Question 4

PICC line is an example of..

Answer 4

central TPN (peripherally inserted central line)

Question 5

TPN associated complications?

Answer 5

INSERTION - air embolism, pneumothorax, cardiac dysarthemia, carotid artery dissection

TPN - hyperosmolar, poor glycemic control, liver dysfunction, cholestasis, pancreatic atrophy, fluid overload, nutrient deficiency

Question 6

Ix for patients on TPN

Answer 6

• daily urea, electrolytes, glucose, until stabilized on TPN
• LFTs twice weekly
• Mg, Cu, Zinc, Phosphate weekly