Answer to Question 1
The initiation of the enteral feeding is appropriate if the patient is hemodynamically stable (Mean arterial pressure >90 mm Hg). The patient's clinical status and diagnosis of severe acute pancreatitis absolutely indicate the initiation of nutrition support. According to current ASPEN guidelines, in severe forms of pancreatitis, it is recommended that enteral nutrition is initiated within the first 24-48 hours of admission. EN will prevent bacterial translocation and the risk of sepsis. Nutritional support is also important due to the increased energy and protein needs associated with this condition. Providing adequate kcal, protein, and nutrients will help to minimize losses and optimize recovery. EN is recommended rather than PN for several reasons. Early initiation of EN has been shown to reduce the rate of mortality and infection, and to decrease the likelihood of future surgeries. In addition, EN will help to stimulate the gut, maintaining the villi and overall gut integrity. PN is only reserved for EN failure or when nutritional needs are higher than what can be met via EN and oral intake.
Answer to Question 2
Oral cavity: this area includes the lips; gums; lining of the cheeks, lips, and under the tongue; the hard palate, the anterior 2/3 of the tongue, and an area of gums behind the wisdom teeth
Pharynx: the throat which leads to the esophagus and is divided into the nasopharynx (upper part by the nose), oropharynx (middle part in the back of the mouth), and hypopharynx (lower-most part)
Larynx: the organ that contains the vocal cords and epiglottis just below the pharynx
Paranasal sinuses and nasal cavity: nasal cavity and the small spaces in the bones surrounding the nose
Salivary glands: includes the glands beneath the tongue (mouth floor) and near the jawbone.