Specialized Nutrition Support: Enteral and Parenteral Nutrition - SAS 17

SPECIALIZED NUTRITION SUPPORT: ENTERAL and PARENTERAL NUTRITION SAS 17  ENTERAL NUTRITION is the provision of nutrients using the GI tract and refers to the USE OF TUBE FEEDINGS that deliver nutrient dense formulas directly to the stomach or small intestine vi...

SPECIALIZED NUTRITION SUPPORT: ENTERAL and PARENTERAL NUTRITION SAS 17  ENTERAL NUTRITION is the provision of nutrients using the GI tract and refers to the USE OF TUBE FEEDINGS that deliver nutrient dense formulas directly to the stomach or small intestine via a  ORAL SUPPLEMENTS weak patients may find it easier to consume oral supplements than regular meals to prevent them of being at risk of becoming malnourished. CONDITIONS THAT CAN INDICATE THE NEED FOR TUBE FEEDINGS: Severe swallowing disorders Impaired motility in the upper GI tract GI obstructions & fistulas Intestinal surgeries Malnourished pts with little or no appetite Extremely high nutrient requirements Mechanical ventilation Mental incapacitation (confusion, neuro disorders or coma)  CONTRAINDICATIONS for TUBE FEEDINGS Severe GI bleeding High-output fistulas Intractable vomiting/diarrhea Severe malabsorption  NGT When patient is expected to be tube fed for LESS THAN 4 WEEKS - Final position of the feeding tube is verified by abdominal X-ray patient’s who requires tube feeding longer than 4 we -OSTOMY ENTEROSTOMY – done either through a surgical incision or needle puncture and is an opening in the abdominal wall for a direct route to the: stomach (GASTROSTOMY) or jejunum (JEJUNOSTOMY)  Gastric feedings are also avoided in patients at high risk for ASPIRATION  PARENTERAL NUTRITION For patients unable to DIGEST or ABSORB nutrients VENOUS ACCESS – peripheral veins in the hand or forearm and the central vein near the heart  MEDICATIONS To avoid the need for a separate infusion site, medications are occasionally added directly to parenteral solutions or infused TOTAL through NUTRIENT ADMIXTURE a separate port in the catheter. (TNA) When a parenteral solution contains DEXTROSE, AMINO ACIDS and LIPIDS  ADMINISTERING PARENTERAL Parenteral nutrition is a complex treatment that requires skills from a variety of disciplines and the nurse who performs direct patient care, plays a central role in administering and monitoring parenteral infusions. DISCONTINUING PARENTERAL NUTRITION Patient must have ADEQUATE GI FUNCTION before parenteral nutrition can be tapered off and enteral feedings begin.