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23 Cards in this Set
- Front
- Back
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Describe the equipment generally needed for eternal nutrition support
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???
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Describe the appropriate methods for administering medications with enternal nutrition support
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????
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Enternal Support
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Via a feeding tube into the GI tract
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Parenternal Support
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Administered directly into the blood stream
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Objectives of Nutrition Support
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Provite nutrition when oral nutrition not possible- maintain/improve nutritional status: weight and lean tissue mass. -Promote woun healing, avoid deficiencies, maintain gut integrity
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24-48 hours promotes benefits
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decrease infectious complications, decrease icu length stay, decrease hospital length of stay
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Indications for need of enternal nutrition
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1) anorexia or no desire to consume nutrition orally
2)Dysphagia-> high risk for aspiration: drawing in by suction or beathing, a common complication of enternal feedings in which foreign material enters the lungs often from GI secretions or the reflux of stomach contents 3)Vegetative state 4) unable to meet nutritional needs via oral diet: cystic fibrosis, critical illness, cva, surgery |
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Delivery: Nasogastric, Nasoduodenal, Nasojejunal
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Nasogastric-nose to stomach, Nasoduodenal- nose to duodenum, Nasojejunal- nose to jejunum
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LONG TERM delivery needed
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Gastrostomy- directly into the stomach
Jejunostomy-directly into the jejunum Percutaneous endoscopic gastrostomy- PEG- endoscopically placed -PEJ |
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Administration Options
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Continuous, Bolus, Intermittent
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Administration: Continuous
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Requires a pump, rate per hour is entered pump(mLs), can be used with any feeding tube, 8-24hour infusion, 75mL/hour x 24hours (30mL=1oz)
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Administration: Intermittent
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Dripped into tube over a 30-90 minute time period, flow is generated by gravity, can be used with any feeding tube
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Administration: Bolus
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Large syringe, used for gastric feedings
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Enternal Formulas
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Disease specific: Hepatic, renal, pulmonary, immune enhancing, concentrated-fluid restricted, high protein, fiber supplemented/no fiber, infant/pediatric, elemental/semi-elemental
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Enternal Formulas: CHO
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-Content- 40-90% calories, almost all are lactose/gluten free
-Glucose intolerance- DM FORMULAS -Pulmonary failure- increase omega-3 fatty acids and antioxidants |
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Enternal formulas: Protein
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-Content: 4-32% calories, standard=12-20%, High N=>20%
-Intact -Peptides |
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Enternal formulas: FAT
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-Content- 1.5-55% of calories, standard 30-40%, high fat contend used in specialized formulas; long chain TG, medium chain TG
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Enternal formulas: Micronutrients and electrolytes
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- most meet needs with 1200mL, low electrolyte/mineral formulas for renal pts
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Enternal formulas: Fiber
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May help normalize GI fxn, Blood glucose control
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Mechanical complications
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Tube pulled out, tube clogs/kinks
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Metabolic Complications
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Electrolyte abnormalties, acid/base abnormalties, hyperglycemia, refeeding syndrome-P, K, and Mg
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Complications: GI
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elevated gastric aspirates, aspiration-GI secretions enters the lungs, Diarrhea and constipation, low flow state, gi bleed
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Transition
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Slowly taper support with increasing oral intake. Provide support: after indegestion of oral meals. Discontinue support when patient meets 60-75% of nurtitional needs with oral intake
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