NutritionNutrition NUR 102 Lab Module I

Enteral Nutrition Definition—administration of nutrients directly into the GI tract Beneficial when oral feedings are not possible, but the stomach or intestines are able to digest nutrients Preferred over parenteral nutrition

Evidence-Based Practice Indications –Impaired swallowing or gag reflex usually related to a neurological process –Nutritional deficit due to decreased food ingestion –Inability to eat related to surgery, injury, or disease

Continued… Complications –Displacement of tube –Electrolyte imbalance –Hyperglycemia –Constipation –Diarrhea –Clogging of the tube –Vomiting –Pulmonary aspiration

Enteral Feeding Types –Nasogastric—a small tube that is passed through the nares into the stomach –Nasointestinal—tungsten-weighted tube inserted through the nares to allow peristalsis to move the tube through the pyloric sphincter into the duodenum or jejunum –Gastrostomy—surgically placed feeding tube inserted into the stomach in the LUQ of the abdomen

Continued…

Equipment Needed NG tube Catheter tip syringe, 60cc Tape or tube fixation device Cup of water or ice chips for the patient Clean gloves

Continued…

Insertion of a Nasogastric or Nasointestinal Tube Refer to Skill 30-1, pg 1014

Verifying Tube Placement X-ray after initial insertion pH of aspirate Air bolus auscultation Aspiration of gastric contents or feeding

NG Tube Irrigation Refer to Skill 30-3, pg 1025

Types of NG Feedings Intermittent or Bolus Continuous drip

Equipment for Feeding Clean gloves 60cc syringe or feeding bag Formula

Feeding Administration Refer to Skill 30-4, pg 1028

Evaluation of Feeding Measure residual per policy—notify MD if >100cc Monitor blood sugar levels per policy Intake and output every 8 hours Monitor lab values—albumin, prealbumin, protein, transferrin

Continued… Daily weights Assess respiratory status Assess level of comfort Assess abdomen—bowel sounds

Gastrostomy Feedings Refer to Skill 30-5, pg 1036

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Parenteral Therapy Definition—specialized nutrition support delivered intravenously Ideal for patients who cannot digest or absorb enteral nutrition Provides amino acids, dextrose, fat emulsions, vitamins, minerals, and trace elements

Central Venous Catheter

PICC Line

Nursing Care Refer to Skill 31-1, pg 1049, Skill31- 2, pg 1-57, and Skill 31-3, pg 1061

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