CSP Enteral & Parenteral Nutrition Support Flashcards

Which enteral formula type is most appropriate for a premature infant requiring concentrated nutrition due to fluid restriction?

Answer: Nutrient-enriched preterm formula (24–30 kcal/oz)

Nutrient-enriched preterm formulas provide higher caloric density and elevated protein, calcium, and phosphorus needed by premature infants under fluid restriction.

What is the primary indication for transpyloric (post-pyloric) enteral feeding in a pediatric patient?

Answer: Severe gastroesophageal reflux with aspiration risk

Post-pyloric feeding bypasses the stomach and reduces aspiration risk in children with severe GERD or delayed gastric emptying.

In pediatric parenteral nutrition, which electrolyte imbalance is most characteristic of refeeding syndrome?

Answer: Hypophosphatemia

Refeeding syndrome is characterized by severe hypophosphatemia as glucose shifts phosphate intracellularly during anabolism.

What is the recommended maximum dextrose infusion rate (mg/kg/min) when initiating parenteral nutrition in a stable term neonate?

Answer: 6–8 mg/kg/min

Starting dextrose at 6–8 mg/kg/min for term neonates matches hepatic glucose oxidation capacity and avoids hyperglycemia.

Which complication is specifically associated with long-term parenteral nutrition use in pediatric patients?

Answer: Intestinal failure-associated liver disease (IFALD)

IFALD (formerly PN-associated liver disease) occurs due to phytosterols in soy-based lipid emulsions, lack of enteral stimulation, and sepsis in children on long-term PN.

A 3-year-old with short bowel syndrome is transitioning from PN to enteral nutrition. Which strategy best promotes intestinal adaptation?

Answer: Gradually introducing small volumes of enteral feeding while weaning PN

Gradual introduction of enteral feeds stimulates intestinal adaptation via trophic effects while PN is slowly weaned to maintain nutrition.