Nutrition Intervention Lecture Notes PDF 1st Semester 2024-2025

PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES COURSE CODE: NCM 105 Nutrition and Diet Therapy COURSE DESCRIPTION: This course deals with the study of food in relation to health and illness. It covers...

PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES COURSE CODE: NCM 105 Nutrition and Diet Therapy COURSE DESCRIPTION: This course deals with the study of food in relation to health and illness. It covers nutrients and other substances and their action, interaction, and balance in relation to health and diseases and the process by which the human body ingests, digests, absorbs, transports, utilizes, and excrete food substances. It also focuses on the therapeutic and food service aspects of the delivery of nutritional services in hospitals and other healthcare institutions. The learners are expected to develop the competencies in appropriate meal planning and education to a given client. COURSE INTENDED At the end of this course, the students should be able to: LEARNING OUTCOMES: 1. Apply knowledge of physical social, natural, and health sciences and humanities in nutrition and diet therapy; 2. Provide safe, appropriate, and holistic care to individuals, families, population group, and community utilizing the nutrition care process; 3. Apply guidelines and principles of evidence-based practice in nutrition and diet therapy; 4. Practice nursing in accordance with existing laws, legal, and moral principles related to nutrition and diet therapy; 5. Communicate effectively in speaking, writing, and presenting using age and culturally appropriate language in nutrition and diet therapy; 6. Document client care in nutrition and diet therapy accurately and comprehensively; 7. Work effectively in collaboration with inter-, intra-, and multi-disciplinary and multi- cultural teams in providing nutrition care; 8. Practice beginning management and leadership skills using systems approach in nutrition and dietary management of the client; 9. Engage in lifelong learning with a passion to keep current with national and global developments in general, and nutrition and dietary management in particular; 10. demonstrate responsible citizenship and pride of being a Filipino; 11. Apply techno-intelligent care systems and processes in nutrition and diet therapy 12. Adopt the nursing core values in the application of nutrition and diet therapy; 13. Apply entrepreneurship skills in nutrition and diet therapy in the delivery of nursing care. LEARNING MATERIAL I. TITLE: Nutrition Intervention II. OBJECTIVES: At the end of this lesson, the students should be able to: →Identify the nutrition intervention methods appropriate to the patient nutritional needs; describe the different ways of food administration essential for good condition, recovery, and life survival; →Implement safe and quality interventions with the client to address the nutritional needs, problems, and issues. →Analyze the role of everyone, especially the nurses, in being involved to nutrition intervention; provide health education in nutrition and diet therapy to targeted clientele (individuals, family, population group, or community. III. INTRODUCTION: This lesson includes an overview of the different nutrition interventions to people in need of nutritional services. In the nutrition care process, it composes assessment, diagnosis, intervention, monitoring, and evaluation (ADIME), nutrition intervention follows nutrition assessment and diagnosis. It is such an important step since it entails resolving and improving nutrition diagnosis and problem to answer for patient needs and limitations for the recovery and development of the patient conditions and complications. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 1 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES IV. CONTENT: Nutrition Intervention To modify behavior/habits related to nutrition, the environment, or health status for an individual, a target demographic, or the community through purposeful, planned efforts. Nutrition Intervention: It includes two components: planning and implementation. Nutritional Interventions are considered situational health interventions/actions. By offering guidance, instruction, and the food component of a particular diet, this Intervention aims to: resolve and improve the nutrition diagnostic. The tactics are chosen to alter dietary consumption, understanding of nutrition, contextual factors, or accessibility to supportive care and services. It offers the framework for assessing results and tracking progress. Health and Social Behavior: the foundation/basis for dietary changes/nutritional interventions and an evaluation/assessment of their effects/impact. Basis for Nutritional Interventions: Diet is one of the most significant/important and changeable/modifiable lifestyle factors that affect people's health. Nutritional treatments are required to lower morbidity and mortality through dietary change because under- and overnutrition both contribute to morbidity and death. They can be put into practice through policy, for instance, at the individual, local, or national level. The goal/purpose of a nutrition intervention is to address/address or enhance/improve the nutrition diagnosis or problem by offering guidance, education, or the food portion of a particular diet or meal plan that is catered to the patient's or client's requirements/needs. Determining a Nutrition Intervention: The choice of a nutrition intervention is driven by the nutrition diagnostic and its causation/etiology. To alter dietary consumption, nutrition-related knowledge or behavior, environmental factors, or accessibility to supportive care and resources, nutrition intervention options are chosen. Monitoring progress and evaluating results are based on nutrition intervention goals. Terminology for nutrition intervention is organized in 4 domains (categories) Food and/or Nutrient Nutrition Education Nutrition Counseling Coordination of Delivery Nutrition Care Individualized A formal Establishing priorities, Coordination of technique/approach to procedure/process to goals, and individualized nutrition treatment with providing food and teach/instruct, train, or action plans for food, other medical nutrients. impart knowledge to a nutrition, and physical professionals, patient or client to assist activity that identify and organizations, or them in freely managing cultivate responsibility for agencies that can help or changing their food, self-care to cure a with managing or nutrition, and physical condition already present treating nutrition- activity choices and and promote health is a related behavior to maintain or supportive approach issues/problems enhance/improve health defined by a cooperative counselor-patient relationship. *Patient/client refers to individuals, groups, populations, family members, and/or caregivers Use of nutrition intervention terminology: Nutrition intervention. is completed in two separate - but connected steps: planning and implementing. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 2 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES Planning the nutrition intervention involves: a. putting nutrition diagnoses first (prioritizing) b. referencing/consulting the Evidence-Based Nutrition Practice Guidelines of the Academy and other practice recommendations/guidelines c. identifying each nutrition diagnosis' patient-focused desired outcomes d. speaking/conferring with the patient, client, or caretakers e. creating an intervention plan for nutrition and related tactics/strategies f. determining the duration/time and frequency of care g. determining the resources required. Implementation is the action phase and involves: a. Sharing/communicating the nutrition care plan with others b. executing/carrying out the plan Critical thinking skills: Establishing priorities and goals Outlining the recommended diet/nutrition prescription or general strategy/basic plan Establishing multidisciplinary relationships Starting/initiating nutritional, behavioral, and other interventions Adapting/matching nutrition intervention techniques to the needs of patients or clients, nutrition diagnosis, values Selecting a course of action from a range of options Determining when and how often to provide care FOOD ADMINISTRATION What is enteral feeding? Enteral feeding → refers to the process of ingesting food through the GI tract. The mouth, esophagus, stomach, and intestines make up the GI tract. Enteral feeding→ refers to food that is consumed orally or by a tube that is inserted into the stomach or small intestine. Enteral feeding is most frequently used to refer to tube feeding in the medical context. A person receiving enteral nutrition typically has a disease or injury that prohibits them from consuming a normal diet by mouth, but their gastrointestinal tract is still healthy. They can eat and maintain their GI tract functioning thanks to tube feeding. Enteral nutrition is a method of giving persons who are unable to chew and swallow like others life-sustaining nutrients and fluids. Internally, a surgical opening is made in the digestive system. From there, food in liquid form and water are provided. This enables the individual to get the nutrients they require to live a healthy life. Enteral Feeding relates to the oral or tube-based administration of food and nutrients into the gastrointestinal tract (GIT). It is designed for individuals who have a healthy GIT but are unable to consume the necessary nutrients orally, as well as for those who have poor digestion or are unable to absorb nutrients. Enteral nutrition or “Tube Feeding”→ a method of feeding someone by inserting a tube into their nose, stomach, or small intestine. A nasogastric tube or nasoenteral tube is a tube inserted via the nose. A gastrostomy is a tube that enters the stomach through the skin. A procedure known as percutaneous endoscopic gastrostomy may be used to implant it there. (PEG). A jejunostomy is a tube placed into the small intestine. A procedure known as percutaneous endoscopic jejunostomy (PEJ) may be used to put it there. To be more specific, there are different Types of Enteral Feeding The American College of Gastroenterology lists six different categories of feeding tubes. Depending on how they exit the stomach or intestines, these tubes may have additional subtypes. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 3 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES A doctor will decide where to put the tube based on your digestive capacity, the size of the tube required, and the duration of the required enteral feeds. In addition, an enteral formula will be selected by a medical professional based on the patient's nutritional requirements, digestive capacity, and tube location. Enteral feeding tubes often come in the following forms : 1. Nasal-gastric tube (NGT) travels from the nose to the stomach. 2. Orogastric tube (OGT) travels from the mouth to the stomach. 3. Nasojejunal and nasoduodenal tubes are two variants of the nasoenteric tube, which originates in the nose and finishes in the intestines. 4. The oroenteric tube travels from the mouth to the intestines. 5. A gastrostomy tube (subtypes include PEG, PRG, and button tubes) is inserted through the skin of the abdomen and into the stomach. 6. Jejunostomy tubes (subtypes include PEJ and PRJ tubes) are inserted through the skin of the abdomen and directly into the intestines. Enteral feeding→ relates to the insertion of a tube directly into the (GIT) to provide food and nutrients. It is designed for individuals who have a healthy GIT but are unable to consume the necessary nutrients orally, as well as for those who have poor digestion or are unable to absorb nutrients. ▪ administration of food via the GIT ▪ The state of having a feeding tube in place. ▪ using the term "specialized formula feedings" Its use can range from supportive therapy, when the tube provides some of the required nutrients, to primary therapy, where the tube provides all the required nutrients. Most kids who get EN can keep eating orally to fulfill the enjoyable and social components of eating. For the sake of their growth, all newborns and early children require oral-motor stimulation. When a child or infant's GIT is healthy but they are unable to consume enough food orally to meet their nutritional needs, TF is employed. When is enteral feeding used? If you are unable to consume enough calories to meet your nutritional demands, tube feedings may be required. This might happen if you are physically unable to eat, cannot eat securely, or if your caloric needs have gone beyond what you can consume. You run the risk of going hungry, losing weight, and developing extremely significant health problems if you do not eat enough. There are several potential causes for this. The following are some of the more prevalent underlying causes for enteral feeding : 1. a stroke, which could make it difficult to swallow 2. cancer, which can make it challenging to eat due to exhaustion, nausea, and vomiting 3. significant health issue or injury that affects one's energy level or capacity to eat 4. incapacity to eat or failure to flourish in newborn toddlers or infants 5. chronic sickness that causes the body to be under stress and makes it challenging to consume enough nutrition 6. neurological or mobility conditions that require additional calories while making it harder to consume 7. gastrointestinal (GI) malfunction or disease, while this may necessitate intravenous (IV) feeding Enteral Nutrition Nutrition delivered by a tube inserted into the small intestine or stomach. A nasogastric tube, a percutaneous gastrostomy tube, or a jejunostomy can all be used to do this. Exclusion Enteral Nutrition (EEN) A type of diet in which a patient receives zero calories, minerals, or vitamins orally and only receives them through tube feedings. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 4 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES Partial Enteral Nutrition Feeding patients receiving partial parenteral nourishment via a tube or orally with extra food that is high in protein, calories, and other nutrients. Possible complications of enteral feeding The enteral feeding procedure has various potential drawbacks. Among the most typical are: 1. Aspiration occurs when food enters the lungs. Aspiration is the evacuation of fluid or tissues from the body as well as the audible breath that precedes or includes a speaking sound. 2. When someone is very undernourished and begins taking enteral feeds, they may experience refeeding syndrome, a serious electrolyte imbalance. 3. infection of the insertion site or tube 4. nausea and vomiting that may be brought on by too-large or too-fast feeding, as well as by a sluggish stomach emptying 5. skin rashes/irritation where the tube was inserted 6. due to a watery diet or perhaps medicine, diarrhea 7. dislodging of a tube 8. tube blockage, which could happen if it is not adequately cleansed Enteral feeding rarely results in long-term consequences. As your body adjusts to eating solid foods again, you could have some stomach discomfort when you start eating normally again. Who should not have enteral feeding? 1. If a person's stomach or intestines are not functioning properly, that is the main reason they would not be able to receive enteral feeds. 2. Enteral feedings are probably not beneficial for someone who has a bowel obstruction, ischemic bowel, or a severe intestinal condition like Crohn's disease. Ischemic bowel disease – is brought on by insufficient oxygenated blood flow to the intestines. Depending on how much damage is caused by a lack of oxygenated blood, the severity of ischemic bowel disease can range from mild to severe. A chronic, or long-lasting, disease that inflames the digestive tract is called Crohn's disease. It falls under the category of inflammatory bowel illness. It can affect any area of the gut, from the mouth all the way down to the anus, and is also known as ileitis or enteritis. However, the ileum, which is located at the bottom of the small intestine, is typically the impacted area. Symptoms include pain, discomfort, and intestinal ulcers. The outlook Enteral nutrition is frequently used as a temporary fix while someone is recovering from an illness, an accident, or surgery. Most patients who receive enteral nutrition resume regular eating. For persons with mobility issues or kids who have physical limitations, enteral feeding is sometimes employed as a long-term treatment. When a patient is critically ill or elderly and unable to meet their nutritional needs, enteral nutrition may be employed to extend their lives. Each situation calls for a careful consideration of the morality of enteral feeding as a life-extending technique. You or a loved one may feel like enteral feeding is a difficult adjustment. This change can be made with assistance from your physician, nurses, a dietitian, and home health care specialists. Advantages of TF/EN The youngster benefits from it by having better growth and nutritional status as well as frequently having better primary conditions. Is required for children who cannot safely eat because their airways need to be protected to prevent or lower the danger of aspiration. physiologically advantageous in preserving gut function and integrity LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 5 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES Improvements in bowel and hydration function as well as consistent medication use are further advantages. TF is less expensive and safer. Because there are so many options for the components used in tube feeding, various dietary adjustments are conceivable, depending on the sickness and recommended diet. Theoretically, EN is superior to PN in several ways, including cost (less expensive), convenience, reduced risk of infection problems, and improved host immunological function. Disadvantages of TF/EN An aggressive EN in a child with gastroesophageal reflux may increase the risk of aspiration or vomiting. diarrhea, skin deterioration, or anatomical disturbance An obstructed or dislodged feeding tube is considered a mechanical disadvantage. Hyperglycemia and hyperphosphatemia are metabolic concerns. Hyperglycemia – Excessive blood sugar "blocks off," obstructs, and causes feeding tubes to become dislodged or clogged. Hyperphosphatemia – excessive levels of phosphorus or phosphate in the blood Children who are malnourished or who are at danger of malnourishment can gain from TF. If present in 1 or more of the factors, TF is taken into consideration: 1. incapable of obtaining at least 80% of oral energy through food; 2. More than 4 hours each day are spent on feeding; 3. weight loss for three months with no weight gain (less for younger infants and kids); 4. less than the age and sex 5th percentile for weight for height; 5. Triceps skinfold is below age-specific 5th percentile; 6. less than or equal to 3.0g/dl of serum albumin If the kid has an oral-motor feeding difficulty, an interdisciplinary team (a doctor, a nutritionist, a caregiver, and an occupational or speech therapist) should decide whether to begin TF. The child needs medical evaluation prior to the initiation of TF for the following reasons: 1. excluding any potential barriers to enteral feeding; 2. identifying potential digestive issues, such as gastroesophageal reflux and aspiration risk. 3. selecting the best feeding delivery site, such as the jejunum, duodenum, or stomach; 4. deciding on a suitable oral-motor stimulation program A feeding tube is surgically or nasally implanted. Factors on the choice of placement of feeding tube: 1. choice/preference of caregiver(s); 2. anticipated time frame/expected period for TF; 3. local resources for resolving issues/complications should they arise 4. family's capacity to acquire the feeding methods required by placement Oral-motor issues might become better with development, patience, and therapy. Each enteral feeding method can be reversed. The same cautious consideration and frequently thorough research that went into the decision to start EN must be made when disconnecting it. The doctor's dietary recommendations and the patient's condition should all be considered while adjusting the feeding schedule. Administration of Tube Feeding: Bolus feedings, continuous drip feedings, or a combination of the two methods can all be used to administer tube feedings. The ideal feeding method is a mix of oral and tube feeding that works with the schedule of the child and family. The inappropriate administration of formula is the cause of many tube feeding difficulties. a. Four to eight times a day, bolus feedings are administered, with each feeding lasting between 15 and 30 minutes. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 6 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES Advantages of bolus feedings Bolus feedings more closely resemble a regular feeding schedule/pattern, ▪ more practical, convenient ▪ cheaper if a pump is not required. Bolus feedings allow the patient to walk around freely, preventing the youngster from being bound to a feeding bag. Disadvantages of bolus feedings: ▪ more easily aspirated than continuous drip feedings, ▪ They may cause bloating, cramps, nausea, and diarrhea in certain kids. When a child needs a big amount of formula or needs to be fed continuously, bolus feeding them might not be an option. b.) Continuous drip feeding→ can be sent every day for an endless amount of time without interruption. It is better to keep feedings at 18 hours or fewer, though. It is not advisable to feed a child continuously because it restricts their mobility and could raise their insulin levels, which could lead to hypoglycemia. For volume-sensitive individuals, it is frequently used for 8 to 10 hours at night so that smaller bolus feedings or oral feedings can be used during the day. Continual drip feeding can be administered using an infusion pump or a gravity drip. A more effective delivery mechanism than a gravity drip is an infusion pump. Gravity drips may have variable flow rates; thus, it is important to check them periodically. Advantage of continuous feeding: Children who are sensitive to volume, are at a high risk for aspiration, or have gastric reflux may handle it better. It is possible to administer it at night to avoid interfering with daytime activities. more calories can be used for growth because of increased energy efficiency. For youngsters who are severely malnourished, this may be crucial. Stool output is decreased, something to keep in mind for a youngster who has had chronic diarrhea. The management of newborns with short bowel syndrome, intractable diarrhea, necrotizing enterocolitis, and Crohn's disease has been beneficial when elemental formula is continuously infused. Disadvantage of continuous feeding: restrict ambulation: although feedings can be arranged for nighttime and naptime feedings, the child is "tied" to the feeding apparatus during the infusion. Additionally, the price is higher due to the price of the pump and any additional feeding supplies that could be required. As continuous feeding may affect the blood levels of some medications, a child's medicine needs to be considered. 7 Formula Blending Tips A patient who is medically stable and has a family who has the skills, desire, free time, and dedication to properly prepare the meal is a good candidate for mixed feedings. These people must be able to adhere to directions and food safety regulations. To make sure the appropriate supplies and resources are used, RDNs must keep an eye on their patients and offer assistance and guidance. While blended whole-food feedings are a new practice with scant research and few established guidelines for use, the following advice can help ensure safe preparation: 1. Use separate cutting boards, wear gloves, wash your hands frequently, and thoroughly wash your produce. 2. Formulas should be kept cold and discarded after 24 hours. 3. Jars of pureed baby food are suitable additions to the blender to assist in achieving nutritional objectives. 4. Unpasteurized juice or milk, raw shellfish, and undercooked food are not advised. 5. The best way to provide feedings is multiple times per day, however, if necessary, a pump Within two hours, the feeding is finished. 6. To boost calories and necessary fatty acids, use healthy fats and oils like avocados or vegetable oils. 7. Steer clear of overly processed meals like cookies and potato chips. To ensure appropriate nourishment, mix up the fruits, vegetables, grains, and protein-rich foods. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 7 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES Tube Feeding Preparation 1. Keep the unopened goods in a cool, dark place away from direct sunlight. 2. Prior to handling the products, wash your hands. 3. Before opening, give the can or bottle a good shake and clean the top. 4. When the product is at room temperature, administer the feeding. 5. Any unused product should be covered and kept in the fridge. 6. The product should only be kept for up to 24 hours; any leftovers should be thrown away. 7. When delivering the feeding product through the feeding tube after it has been chilled, let the food to reheat to room temperature by leaving it out on the counter for roughly 15 minutes. Never microwave anything used for tube feeding. Cleaning the Tube Site and Equipment 1. Every day, the area needs to be cleansed with soap and water. 2. Care for the location as directed by the doctor. 3. Sets of tube feeding bags can be washed in soap and water. *Be sure to also flush the tubing with soapy water. *If they are complete, tube feeding bag sets are OK. *Rinse under running water to remove all soap from the bag and the tubing. *Canisters and syringes can be cleaned with soap and water or put on the top rack of a dishwasher. If they are in good condition, they can also be used. 1. To combine and liquefy ingredients more effectively, use enough liquid. 2. Never heat or warm up TF because doing so will cause it to curdle. 3. To prevent clogging, avoid using coarse, high-fiber foods; instead, use low-fiber foods, and after blending, do not forget to strain it. 4. It is recommended to use homogenized milk rather than plain pasteurized milk when using liquid milk because butterfat tends to stick to the inside of blenders. 5. Use prepared foods that have been commercially pureed as infant food for convenience. What Is Parenteral Nutrition - created for people who are unable to take or absorb nutrients administered enterally. Parenteral Nutrition (PN)→ intravenous nutrition therapy for patients who are unable to consume or absorb enough food through tube feeding formula or orally to maintain good nutritional status may include protein, carbohydrate, fat, minerals, electrolytes, vitamins, and other trace elements. Receiving the proper nourishment in a timely manner can aid in preventing complications and play a crucial role in a patient's recovery. Total Parenteral Nutrition (TPN) is another name for parenteral nutrition. The “Rule of Five”: a reason for TPN; describes a patient who has gone five days without eating and is unable to eat with EN. The “Weight Loss Rule”: TPN is also indicated in patients who have lost at least 7% of their body weight (BW) in the previous two months and/or are unable to eat. Enteral vs. Parenteral Feeding Enteral feeding might not always be an option. Parenteral feeding may be necessary if you are at risk for malnutrition and do not have a functioning GI system. Parenteral Feeding→ refers to providing nutrients to a person through their veins. To receive liquid nutrition, a sort of venous access device, such as a port or a peripherally inserted central catheter (PICC or PIC line), will be implanted. Peripheral Parenteral Nutrition (PPN)→ Peripheral parenteral nutrition (PPN) is the term used when this is your supplemental nutrition. Total Parenteral Nutrition (TPN).→ while you are receiving all your nutritional needs via IV. In many cases, parenteral nutrition can save a person's life. However, if possible, enteral feeding should be used. Enteral nutrition can support immune system health and most closely resembles regular meals. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 8 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES Types of PN: 1. Peripheral Parenteral Nutrition (PPN) – Other nutrients must be administered through smaller veins, typically in the forearm, if PN is the primary source of sustenance. Other terms: CVN – Central Venous Nutrition PVN – Peripheral Venous Nutrition 2. Central-Parenteral Nutrition or Total Parenteral Nutrition (TPN) – In the event that PN is the source of sustenance, nutrients are centrally pumped into a vein with a large diameter, such as the superior or inferior vena cava or the jugular vein. When multiple malnourished patients are receiving chemotherapy and significant surgery, this is often reserved for serious complications. Who Receives Parenteral Nutrition? Parents give their children parenteral nourishment. It can be administered to adults, babies, and kids. When necessary, parenteral feeding can sustain a person's health. Parenteral nutrition is frequently utilized for a brief period before being reduced or stopped when the patient starts eating enough by mouth or switches to tube feeding. When necessary, parenteral feeding can sustain a person's health. Parenteral nutrition is frequently utilized for a brief period before being reduced or stopped when the patient starts eating enough by mouth or switches to tube feeding. Parenteral nutrition The medical term for injecting a particular form of food through a vein (intravenously) is total parenteral nutrition. The treatment's objective is to treat or stop malnutrition. Parenteral nutrition delivers a variety of liquid nutrients, such as electrolytes, proteins, lipids, carbs, and vitamins. Some people augment their gastrointestinal (enteral nutrition) feeding with parenteral nutrition, while others utilize it exclusively. Parenteral nutrition is used by those whose digestive systems either cannot process or cannot accept enough food consumed orally. Intravenous nutrition is referred to as home parenteral nutrition when it is utilized outside of hospitals. Home parenteral nourishment may be required for several weeks, months, or perhaps the rest of the patient's life. One may be needing Parenteral Nutrition for the following reasons : 1. Cancer. An obstruction of the bowels brought on by digestive tract cancer could make it difficult to consume enough food. Chemotherapy, for example, might make it more difficult for your body to absorb nutrients. 2. Crohn's disease. An inflammatory condition of the intestine known as Crohn's disease can cause pain, intestinal narrowing, and other symptoms that influence how much food is consumed, how it is digested, and how much of it is absorbed. 3. Short bowel syndrome. You do not have enough gut in this condition to absorb enough of the nutrients you eat. It might be present at birth or arise from surgery that removed a sizable portion of the small intestine. 4. Ischemic bowel disease. Due to the bowel receiving less blood, this could lead to problems. 5. Abnormal bowel function. This makes it difficult for food to pass through your intestines, which leads to several symptoms that make it difficult to eat enough. Surgical adhesions or anomalies in intestinal motility might cause aberrant bowel function. These could be brought on by radiation enteritis, neurological problems, and a variety of other illnesses. Parenteral Nutrition Nutrition must be given to the patient directly into the bloodstream if the patient's gut cannot be utilized to absorb nutrients. LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 9 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES These factors contribute to this sort of feeding: 1. blockage or ileus, a condition in which the intestine is blocked or unable to function 2. Gut perforations where feeding occurs will make infections worse. 3. When a significant portion of the gut has been removed, the patient suffers small bowel syndrome and cannot absorb enough nutrients. 4. When the gut is functionally short and has diseases that prevent it from absorbing nutrients adequately Parenteral nutrition is drip-fed into the bloodstream gradually. It is typically administered by a central venous line into a large vein close to the heart because it can be extremely irritating to blood vessels. put in the neck, chest, or upper arm Parenteral feeding use can occasionally lead to major issues including blood infections or a biochemical imbalance. Patients therefore require close supervision. Some patients might be taught how to provide their own parenteral nourishment at home (Home Parenteral nourishment) if the impairment with gastrointestinal function is permanent or likely to last for a long time. The choice between enteral and parenteral nutrition Parenteral nutrition is rarely chosen over enteral feeding since it is more physiological, easier, less expensive, and less complex. The more complicated forms of enteral nutrition, such gastrostomy and jejunostomy, require extensive treatments, and even nasogastric feeding needs attention. ▪ Therefore, it is crucial that any institution adopting artificial nutrition adhere to strict policies and guidelines. A patient may require various types and dosages of artificial nutritional support at various stages of their disease, making the decision between enteral and parenteral feeding sometimes challenging Parenteral and enteral feeding may both be required at certain periods. In this area, the constant counsel of a nutrition support staff is essential. V. REFERENCES: 1. slideshare.net/damithagunawardane/nutritional interventions 2. omicsonline.org/scholarly/nutritional-interventions-journals-articles-ppts-php 3. healthknowledge.org.wk/public-health-textbook/disease-causation-diagnostic/2e-health-social-behavior/nutrition- interventions 4. andeal.org/vault/2440/web/files/20140527-NI%20Snapshot-pdf 5. Dix, M. October 30, Updated on October 30, 2018, healthline.com/health/enteral-feeding 6. study.com/academy/lesson/enteral-nutrition-definition-guidelines.html 7. Shiel,W.C.William, www. medicinenet.com/script/main/art.asp?articlekey=39500 8. winchesterhospital,org/health-library/article?id=06868 9. medicalnewstoday.com/articles/151620 10. Caudal, M.L.C., Basic Nutrition and Diet Therapy, Textbook for Allied Health, 2nd Edition, C & E publishing, Inc. Quezon City, 2019 11. bapen.org.uk/nutrition-support/assessment-and-planning/enteral-and-parenteral-nutrition 12. depts.washington.edu/growing/Nourish/Tubes.htm 13.depts.washington.edu/growing/Nourish/Tubetech.html/administration%20of%20Tube%20Feedings 14.foodsand nutrition.org/July-august-2016/risks-benefit-diy-belended-tube-feedings/ 15. myshepherdconnection.org/tube-feeding-guide 16. nutricare.org/about_clinical_nutrition/what_is_parenteral_nutritionm/ 17. mayoclinic.org/tests-procedure-total parenteral-nutrition/about/pac-20385081 18.. medical-dictionary.thefreedictionary.com/nutritional status LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 10 of 11  PAMANTASAN NG CABUYAO COLLEGE OF HEALTH AND ALLIED SCIENCES VI. ASSESSMENT TASK: (Activity/assignment - be sent to respective sections) Rubrics Poor 1 Fair 2 Good 3 Excellent 4 Focus on No attempt has been Some part of the work is Most part of the work is Entire work is related to Assigned Topic made to relate the related to the assigned topic, related to the assigned the assigned topic and work to the assigned but a reader does not learn topic. The work wanders allows the reader to topic. much about the topic. off at one point, but the understand much more reader can still learn about the topic. something about the topic. 20% Reflection of Little or no explanation Does not go deeply into the Relates learning with Shows great depth of Personal or reflection on reflection of learning, research and project, knowledge and Learning learning, no or few generalizations, and limited personal and general learning, reveals details to support insight, uses some detail. reflections included, uses feelings and thoughts, reflection. concrete languages. abstract ideas reflected through use of specific details. 20% Mechanics Many grammatical A few grammatical spelling Almost no grammatical No grammatical spelling or punctuation or punctuation errors. spelling or punctuation spelling or punctuation errors. errors. errors. 20% Organization Ideas seem to be The work is a little hard to The work is well The work is very well randomly arranged. No follow. Paragraphs are organized. One idea may organized. One idea or effort at paragraph unclear. The transitions are seem out of place. Clear scene follows another organization. sometimes not clear. transitions are used. in a logical sequence with clear transitions. 20% Conclusion Incomplete and/or The conclusion does not The conclusion restates The conclusion is unfocused. adequately restate the the learning. engaging and restates learning. personal learning. 20% Total: 100% LECTURE NOTES COMPILATION 1st Semester 2024-2025 Page 11 of 11