MNA M osby ’ s Long Term Care Assistant Chapter 25 Nutritional Support and IV Therapy

Nutritional Support Many people cannot eat or drink because of illness or injury. Special orders needed

Aspiration Breathing fluid, food, vomitus or an object into the lungs

Enteral Nutrition Causes of inability to ingest, chew or swallow food: Cancer Trauma Coma Dysphagia Dementia

Types of Feeding Tubes Nasogastric Tube (NG) Inserted through the nose and into the stomach

Types of Feeding Tubes Nasointestinal Tube Inserted through the nose and into the small intestines

Types of Feeding Tubes Gastrostomy Tube Inserted into the stomach surgically

Types of Feeding Tubes Jejunostomy Tube Inserted surgically into the jejunum of the small intestines

Types of Feeding Tubes Percutaneous endoscopic gastrostomy Tube (PEG) Doctor inserts the feeding tube with an endoscope. Endoscope allows visualization. Incision is made into the stomach for correct tube placement.

Types of Feeding Tubes (PEG)

Formulas for Feeding Doctor orders type of formula Nurse administers feeding. Most contain protein, carbohydrates, fats, vitamins and minerals

Feeding Times Intermittent Continuous Given at certain times Given over 24 hours

Observations for Feeding Tubes Patient is at risk for Diarrhea Aspiration Constipation

Feeding Tubes Report: Nausea/Vomiting Distended abdomen Redness, drainage at insertion site Diarrhea Difficulty breathing

Feeding Tubes Regurgitation Backward flow of stomach contents into the mouth

Feeding Tubes Position in Semi- fowlers Avoid left- lying position Preventing Aspiration

Feeding Tubes Comfort Measures Usually not allowed to eat or drink Oral care Q2

Parenteral Nutrition Giving nutrients through a catheter inserted into a vein

Parenteral Nutrition Often called TPN Nutrients do not enter the GI tract Go directly into the vein

Parenteral Nutrition Contains: water protein carbs vitamins minerals

Parenteral Nutrition Reasons for TPN: Disease, injury, surgery to GI tract Severe trauma, infection or burns NPO for more than 5-7 days Coma Cancer

Parenteral Nutrition Report: Fever, chills Chest pain SOB Cough N/V Diarrhea

IV Therapy Intravenous Therapy Giving fluids through a catheter inserted into a vein

IV Therapy Provides fluids Replace vitamin and mineral loss Give drugs or blood

IV Sites Peripheral Central venous Away from the center of the body. Ex: arm, leg, scalp Close to the heart Ex: subclavian, jugular

IV Equipment

Assisting with IV Therapy Report bleeding Protect the bag, tubing, catheter, site Observe the flow rate Report empty bags

Review IV therapy is giving fluid thru a needle or catheter inserted into a vein. TrueFalse

Review Regurgitation is the swelling of body tissue TrueFalse

Review Persons with feeding tubes need frequent oral hygiene. TrueFalse

Review If the alarm sounds on the IV pump, turn it off. TrueFalse

Review You are responsible for inserting feeding tubes. TrueFalse

Review You are never responsible for IV therapy TrueFalse

Review A naso gastric tube is inserted directly into the stomach TrueFalse

Review A gastrostomy tube is a tube inserted into the stomach