Enteral and Parenteral Feeding Flashcards
What pts would get enteral feeding?
Pt’s with face(oral) or esophagus issues with working GI.
Ex: dysphagia, stroke, MS, parkinson’s disease,
What are some sx seen in dysphagia?
When assessing pt, what do you watch for?
excessive drooling, chest pain, gruggling, increased clearing throat
Watch pt swallow= see if they are able to form bolus and swallow, dysphagia can be on both sides or just one side
Thyroid deviation can cause what and why?
Obstruction when pt tries to swallow, also known as esophageal dysphagia
How is TMP given to pt? What are some precautions when it goes to the temp.?
TMP is given in EN feeding thru tube.
TMP should be a room temp. when you give to pt because cold TMP can cause stomach cramps. However, TMP should not be kept at room temp. for more than 30 minutes due to bacterial growth. So keep in refrigerator until 30 min. b4 feeding.
Tell me about positioning of EN feeding.
Pt should be placed in semi-folwer during feeding, and 30-45 min. after feeding as to prevent aspiration into lungs causing pneumonia.
What kind technique is used when inserting EN tube and during care?
Clean technique, sterile technique is unnecessary
How to prevent clogs in tube?
Flush b4, during, and after med. administration.
Pt needs 1500mL/day to prevent dehydration, space out giving pt water every 4 hours.
How measure feeding tube that is appropriate for pt?
Measure from nose to earlobe to xyphoid process
How to confirm placement?
Initial confirmation of placement AlWAYS X-ray, and then after that aspirate stomach contain to check pH in combination with tape on nose and tube.
What is the pH of HCL?
2-3
What could cause dislodgement of tube?
Coughing, vomiting
What is residual?
And how do you know you have residual? What are you next steps if you know pt have residual in stomach?
Residual is undigested nutrient still in stomach an hour after feeding when it should have been digested.
If pt still has more than 100mL an hour after feeding, pt is not digesting the food. When was the last BM? Is there any abd. distension (obstruction in GI)? Check bowel sounds and for pain.
Pt on EN feeding has diarrhea. What could cause this?
What could you do about it?
Intolerance to TMP, rate of feeding too fast
Slow the rate of feedings and change formula of TMP.
What is parenteral feeding indicated?
When pt’s GI doesn’t work.
Ex: pt has complicated surgery (b/s need for calories and protein increased), obstruction in GI, intractable diarrhea
What pts would need closer monitor when using fat emulsion PN?
Pts with pancreatitis, liver failure, and respiratory diseases
