Question 1

Which of the following are all risk factors for refeeding syndrome?

Accepted Answer

C) Low body weight, no or reduced food intake for more than 10 days, low levels of potassium, phosphate or magnesium before feeding, and a history of alcohol or drug misuse are recognized risk factors for refeeding syndrome. This condition can occur when feeding is restarted after a period of malnutrition or starvation, leading to potentially fatal shifts in fluids and electrolytes.

Question 2

According to the European Society of Intensive Care Medicine (2017) early enteral feeding should be delayed if the affected person is experiencing which of the following:

Accepted Answer

The European Society of Intensive Care Medicine (2017) guidelines recommend delaying early enteral feeding in cases of uncontrolled shock, overt bowel ischaemia, and significant upper GI bleeding, including situations where gastric aspirates exceed 500 mls for 6 hours. These conditions can compromise the gut's integrity and function, making enteral feeding potentially harmful.

Question 3

According to the 'nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition guideline' (NICE 2006), when should healthcare professionals consider enteral tube feeding in people who are malnourished or at risk of malnutrition?

Accepted Answer

Enteral tube feeding should be considered for individuals who are malnourished or at risk of malnutrition and have inadequate oral intake but possess a functional, accessible gastrointestinal tract. This allows for the direct delivery of nutrition to the digestive system.

Question 4

What is the normal pH of gastric aspirates?

Accepted Answer

The normal pH of gastric aspirates is less than 5.5, reflecting the acidic environment of the stomach due to gastric acid secretion.

Question 5

What volume of sterile water to BAPEN recommend flushing enteral feeding tubes with between medications?

Accepted Answer

BAPEN recommends flushing enteral feeding tubes with 10 ml of sterile water between medications.

Question 6

Sheena is admitted to intensive care and is likely to be intubated and ventilated for several days.
-How quickly should nutritional replacement be commenced after admission?

Accepted Answer

Nutritional replacement should be commenced as soon as possible after admission to intensive care, as critically ill patients are at high risk of malnutrition and its associated complications.

Question 7

Sheena is admitted to intensive care and is likely to be intubated and ventilated for several days.
-What would be the most appropriate route to give her the nutrition?

Accepted Answer

Nasogastric feeding is the most appropriate route for patients who are intubated and ventilated, as it allows for enteral nutrition, which is preferred over parenteral routes when the gastrointestinal tract is functional.

Question 8

Ruby is having a nasogastric tube inserted for feeding whilst she is intubated and ventilated. She appears malnourished and thin.
-How would you know the nasogastric tube is in the stomach?

Accepted Answer

The test pH level of aspirate being 1-5.5 is a method used to confirm that a nasogastric tube is in the stomach, as stomach acid typically has a low pH within this range.

Question 9

Ruby is having a nasogastric tube inserted for feeding whilst she is intubated and ventilated. She appears malnourished and thin.
-What syndrome is Ruby at risk of when the feeding starts?

Accepted Answer

Refeeding syndrome is a potentially fatal condition that can occur when feeding is started in malnourished patients. It is characterized by electrolyte shifts and metabolic disturbances.

Quiz 9: Critical Care Related to the Gastrointestinal System

Which of the following are all risk factors for refeeding syndrome?

According to the European Society of Intensive Care Medicine (2017) early enteral feeding should be delayed if the affected person is experiencing which of the following:

According to the 'nutrition support for adults: oral nutrition support, enteral tube feeding and parenteral nutrition guideline' (NICE 2006) , when should healthcare professionals consider enteral tube feeding in people who are malnourished or at risk of malnutrition?

What is the normal pH of gastric aspirates?

What volume of sterile water to BAPEN recommend flushing enteral feeding tubes with between medications?

Sheena is admitted to intensive care and is likely to be intubated and ventilated for several days. -How quickly should nutritional replacement be commenced after admission?

Sheena is admitted to intensive care and is likely to be intubated and ventilated for several days. -What would be the most appropriate route to give her the nutrition?

Ruby is having a nasogastric tube inserted for feeding whilst she is intubated and ventilated. She appears malnourished and thin. -How would you know the nasogastric tube is in the stomach?

Ruby is having a nasogastric tube inserted for feeding whilst she is intubated and ventilated. She appears malnourished and thin. -What syndrome is Ruby at risk of when the feeding starts?