. Which of the following statements are true?
The patient should have a naso-gastric tube placed and if he is able to tolerate NG feeds, he should be scheduled for PEG tube placement in 2 weeks
Try again! There is no reason to believe the patient will not tolerate nasogastric feeds, as he has a normal functioning gastrointestinal tract. His dysphagia is anticipated to worsen over the course of radiation therapy, and so he requires a long term nutrition options, which in this case would be a long term enteral access in the form of a PEG tube. 2 weeks of naso-gastric feeds will result in an unnecessary delay in PEG and may delay his cancer treatment
The patient is an appropriate candidate for PEG , as he is currently meeting < 60% of his nutritional needs via oral feeds
Correct! This patient’s average caloric needs are approximately 2000-2500kcals/ day (25-30kcals/kg/day) with 80-92gm protein ( 1-1.2g/kg)/ day. He is unable to meet > 60% of his energy and protein needs with his current diet and is thus an appropriate candidate for early and aggressive enteral nutrition support.
The patient should receive parenteral nutrition preferentially, as enteral nutrition may cause tumor growth
Incorrect, try again! If the gut is functional, enteral nutrition is the preferred method of nutrition support and there is no indication to start parenteral nutrition, which is associated with a higher risk of infectious and thrombotic complications. There is no evidence that enteral nutrition affects tumor growth. The benefits of nutrition support in oncology patients far outweighs the theoretical risks of tumor promotion.
The patient is at high risk for malnutrition based on the kind of cancer he has been diagnosed with
Correct! Patients with head and neck, lung and gastrointestinal cancers are at highest risk for malnutrition.
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