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Nutrition 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… Continued… 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 NCLEX Review Questions 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, Skill312, pg 1-57, and Skill 31-3, pg 1061 NCLEX Review Questions
